Provider Demographics
NPI:1003532938
Name:SERENITY HOSPICE LLC
Entity Type:Organization
Organization Name:SERENITY HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KALPESH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAUDHARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-794-8565
Mailing Address - Street 1:3430 BRIARFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-9374
Mailing Address - Country:US
Mailing Address - Phone:419-794-8565
Mailing Address - Fax:419-794-2197
Practice Address - Street 1:3430 BRIARFIELD BLVD
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-9374
Practice Address - Country:US
Practice Address - Phone:419-794-8565
Practice Address - Fax:419-794-2197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based