Provider Demographics
NPI:1578611802
Name:SERENERGY PROFESSIONAL HOME HEALTH SERVICES, LLC.
Entity Type:Organization
Organization Name:SERENERGY PROFESSIONAL HOME HEALTH SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ECKERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-385-3252
Mailing Address - Street 1:13133 STATE ROUTE 374
Mailing Address - Street 2:
Mailing Address - City:ROCKBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43149-9528
Mailing Address - Country:US
Mailing Address - Phone:740-385-3252
Mailing Address - Fax:
Practice Address - Street 1:13133 STATE ROUTE 374
Practice Address - Street 2:
Practice Address - City:ROCKBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43149-9528
Practice Address - Country:US
Practice Address - Phone:740-385-3252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1664410251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health