Provider Demographics
NPI:1609525799
Name:SERENITY DOVES HOME CARE SERVICES
Entity Type:Organization
Organization Name:SERENITY DOVES HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:769-204-3699
Mailing Address - Street 1:PO BOX 1472
Mailing Address - Street 2:
Mailing Address - City:MCCOMB
Mailing Address - State:MS
Mailing Address - Zip Code:39649-1472
Mailing Address - Country:US
Mailing Address - Phone:769-204-3699
Mailing Address - Fax:601-600-2165
Practice Address - Street 1:821 SUMMIT ST
Practice Address - Street 2:
Practice Address - City:MCCOMB
Practice Address - State:MS
Practice Address - Zip Code:39648-3151
Practice Address - Country:US
Practice Address - Phone:769-204-3699
Practice Address - Fax:601-600-2165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care