Provider Demographics
NPI:1114479094
Name:SERENE HOME CARE OF SARASOTA, LLC
Entity Type:Organization
Organization Name:SERENE HOME CARE OF SARASOTA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEGARRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-374-0268
Mailing Address - Street 1:3802 EHRLICH RD
Mailing Address - Street 2:SUITE 309-A
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-2378
Mailing Address - Country:US
Mailing Address - Phone:813-374-0268
Mailing Address - Fax:813-252-6941
Practice Address - Street 1:1903 NORTHGATE BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34234-2143
Practice Address - Country:US
Practice Address - Phone:813-374-0268
Practice Address - Fax:813-252-6941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-26
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care