Provider Demographics
NPI:1508925835
Name:THE SERENITY GROUP, INC
Entity Type:Organization
Organization Name:THE SERENITY GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:LEDARRE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEIGLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-884-8458
Mailing Address - Street 1:8732 EMNORA LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-6102
Mailing Address - Country:US
Mailing Address - Phone:832-884-8458
Mailing Address - Fax:888-224-3820
Practice Address - Street 1:8732 EMNORA LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-6102
Practice Address - Country:US
Practice Address - Phone:832-884-8458
Practice Address - Fax:888-224-3820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX012243251E00000X, 3747P1801X
TX016678251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP7132Medicare UPIN
GAQ43715Medicare UPIN