Provider Demographics
NPI:1407636384
Name:SERENITY HOME HOSPICE INC
Entity Type:Organization
Organization Name:SERENITY HOME HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:OTIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ISOA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-993-3933
Mailing Address - Street 1:3958 ASPEN LANDING LN
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-2322
Mailing Address - Country:US
Mailing Address - Phone:404-993-3933
Mailing Address - Fax:
Practice Address - Street 1:3958 ASPEN LANDING LN
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-2322
Practice Address - Country:US
Practice Address - Phone:404-993-3933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based