Provider Demographics
NPI:1043619786
Name:SERENITY LIVING HOME HEALTH, LLC
Entity Type:Organization
Organization Name:SERENITY LIVING HOME HEALTH, LLC
Other - Org Name:SERENITY LIVING HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:XIOMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:AZCANO
Authorized Official - Suffix:
Authorized Official - Credentials:CHHA, CSCM
Authorized Official - Phone:561-574-9122
Mailing Address - Street 1:1308 E ATLANTIC BLVD
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-6745
Mailing Address - Country:US
Mailing Address - Phone:561-574-9122
Mailing Address - Fax:
Practice Address - Street 1:1308 E ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-6745
Practice Address - Country:US
Practice Address - Phone:561-574-9122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health