Provider Demographics
NPI:1497328215
Name:SERENITY HEALTH CARE LLC
Entity Type:Organization
Organization Name:SERENITY HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:LYERLA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:508-817-0727
Mailing Address - Street 1:892 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-1549
Mailing Address - Country:US
Mailing Address - Phone:508-827-0727
Mailing Address - Fax:
Practice Address - Street 1:892 CENTRE ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-1549
Practice Address - Country:US
Practice Address - Phone:508-817-0727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty