Provider Demographics
NPI:1568065902
Name:SERENITY HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:SERENITY HOME HEALTH CARE, LLC
Other - Org Name:PRECISE LAB SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EVELEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMS
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:919-519-1405
Mailing Address - Street 1:3622 LYCKAN PKWY STE 4007
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-2566
Mailing Address - Country:US
Mailing Address - Phone:919-748-3694
Mailing Address - Fax:919-748-3722
Practice Address - Street 1:3622 LYCKAN PKWY STE 4007
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2566
Practice Address - Country:US
Practice Address - Phone:919-748-3694
Practice Address - Fax:919-748-3722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-18
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care