Provider Demographics
NPI:1003561317
Name:DESERT SERENITY, INC
Entity Type:Organization
Organization Name:DESERT SERENITY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEDALIERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-397-7034
Mailing Address - Street 1:68896 CORRAL RD
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-4214
Mailing Address - Country:US
Mailing Address - Phone:760-397-7034
Mailing Address - Fax:
Practice Address - Street 1:68896 CORRAL RD
Practice Address - Street 2:
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-4214
Practice Address - Country:US
Practice Address - Phone:760-397-7034
Practice Address - Fax:760-377-9003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child