Provider Demographics
NPI:1275999260
Name:ETERNAL SERENITY HOSPICE LLC
Entity Type:Organization
Organization Name:ETERNAL SERENITY HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ESPERANZA
Authorized Official - Middle Name:
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:956-766-7156
Mailing Address - Street 1:3700 W 5 MILE RD
Mailing Address - Street 2:STE. B
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78574
Mailing Address - Country:US
Mailing Address - Phone:956-766-7156
Mailing Address - Fax:888-814-8706
Practice Address - Street 1:3700 W 5 MILE RD
Practice Address - Street 2:STE. B
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78574
Practice Address - Country:US
Practice Address - Phone:956-766-7156
Practice Address - Fax:888-814-8706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-07
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based