Provider Demographics
NPI:1689251522
Name:SERENITY SENIOR LIVING INC, DBA THE HARVEST AT FOWLER
Entity Type:Organization
Organization Name:SERENITY SENIOR LIVING INC, DBA THE HARVEST AT FOWLER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KULJINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-834-5692
Mailing Address - Street 1:1400 E SUMNER AVE
Mailing Address - Street 2:
Mailing Address - City:FOWLER
Mailing Address - State:CA
Mailing Address - Zip Code:93625-2666
Mailing Address - Country:US
Mailing Address - Phone:559-834-5692
Mailing Address - Fax:
Practice Address - Street 1:1400 E SUMNER AVE
Practice Address - Street 2:
Practice Address - City:FOWLER
Practice Address - State:CA
Practice Address - Zip Code:93625-2666
Practice Address - Country:US
Practice Address - Phone:559-834-5692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-26
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility