Provider Demographics
NPI:1093109621
Name:SERENITY HOSPICE AND PALLIATIVE CARE, LLC
Entity Type:Organization
Organization Name:SERENITY HOSPICE AND PALLIATIVE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:DEVINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-501-9014
Mailing Address - Street 1:1305 W HAWK CT
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651-8800
Mailing Address - Country:US
Mailing Address - Phone:208-501-9014
Mailing Address - Fax:888-438-8752
Practice Address - Street 1:132 3RD ST S
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-3715
Practice Address - Country:US
Practice Address - Phone:208-501-9014
Practice Address - Fax:888-438-8752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-20
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based