Provider Demographics
NPI:1457485864
Name:SERENITY HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:SERENITY HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEO
Authorized Official - Middle Name:G
Authorized Official - Last Name:DELA ROSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-240-5633
Mailing Address - Street 1:10701 CORPORATE DR STE 336
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-4017
Mailing Address - Country:US
Mailing Address - Phone:281-240-5656
Mailing Address - Fax:281-240-5669
Practice Address - Street 1:10701 CORPORATE DR STE 336
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-4017
Practice Address - Country:US
Practice Address - Phone:281-240-5656
Practice Address - Fax:281-240-5669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011097251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health