Provider Demographics
NPI:1083208441
Name:SERENITY HOME CARE LLC
Entity Type:Organization
Organization Name:SERENITY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SADIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALASOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-216-5617
Mailing Address - Street 1:4451 W ST ANNE AVE
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-6232
Mailing Address - Country:US
Mailing Address - Phone:602-688-9942
Mailing Address - Fax:602-806-6441
Practice Address - Street 1:7004 W SHUMWAY FARM RD
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-7033
Practice Address - Country:US
Practice Address - Phone:602-688-9942
Practice Address - Fax:602-806-6441
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SERENITY HOME CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness