Provider Demographics
NPI:1033779376
Name:SERENITY HOME CARE & COMPANION, LLC
Entity Type:Organization
Organization Name:SERENITY HOME CARE & COMPANION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANELL
Authorized Official - Middle Name:M
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-275-3355
Mailing Address - Street 1:13500 SW 250TH ST UNIT 4137
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33092-0879
Mailing Address - Country:US
Mailing Address - Phone:786-275-3355
Mailing Address - Fax:
Practice Address - Street 1:25660 SW 133RD AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-6802
Practice Address - Country:US
Practice Address - Phone:786-275-3355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care