Provider Demographics
NPI:1245748524
Name:SERENITY AT HOME CARE, LLC
Entity Type:Organization
Organization Name:SERENITY AT HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KARL
Authorized Official - Middle Name:BRETT
Authorized Official - Last Name:LLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:412-773-0527
Mailing Address - Street 1:4400 OLD WILLIAM PENN HWY
Mailing Address - Street 2:100F
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146
Mailing Address - Country:US
Mailing Address - Phone:412-515-6336
Mailing Address - Fax:
Practice Address - Street 1:4400 OLD WILLIAM PENN HWY
Practice Address - Street 2:100F
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146
Practice Address - Country:US
Practice Address - Phone:412-515-6336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-20
Last Update Date:2018-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA36073601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health