Provider Demographics
NPI:1518436773
Name:SERENITY HOME CARE FACILITIES LLC
Entity Type:Organization
Organization Name:SERENITY HOME CARE FACILITIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:C
Authorized Official - Last Name:NWAEZEAPU
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:213-210-6472
Mailing Address - Street 1:25654 PAPILLON CT
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92585-8878
Mailing Address - Country:US
Mailing Address - Phone:213-210-6472
Mailing Address - Fax:
Practice Address - Street 1:25654 PAPILLON CT
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92585-8878
Practice Address - Country:US
Practice Address - Phone:213-210-6472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty