Provider Demographics
NPI:1073581377
Name:SERENITY ADULT DAY CARE CENTER
Entity Type:Organization
Organization Name:SERENITY ADULT DAY CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:MARTHA
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:330-328-8182
Mailing Address - Street 1:1 CANAL SQUARE PLZ
Mailing Address - Street 2:APARTMENT 1202
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44308-1037
Mailing Address - Country:US
Mailing Address - Phone:330-328-8182
Mailing Address - Fax:
Practice Address - Street 1:730 PORTAGE TRAIL EXT
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-8506
Practice Address - Country:US
Practice Address - Phone:330-328-8182
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN318069251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care