Provider Demographics
NPI:1093381550
Name:A'DIAR SERENITY HOUSE, LLC
Entity Type:Organization
Organization Name:A'DIAR SERENITY HOUSE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-856-3752
Mailing Address - Street 1:21625 CHAGRIN BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5335
Mailing Address - Country:US
Mailing Address - Phone:216-856-3752
Mailing Address - Fax:
Practice Address - Street 1:21625 CHAGRIN BLVD STE 100
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5335
Practice Address - Country:US
Practice Address - Phone:216-856-3752
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-03
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care