Provider Demographics
NPI:1821470063
Name:SERENDIPITY HOMECARE LLC
Entity Type:Organization
Organization Name:SERENDIPITY HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:KYOBE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:339-224-4745
Mailing Address - Street 1:2 SOUTH STA
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02110-2208
Mailing Address - Country:US
Mailing Address - Phone:339-224-4745
Mailing Address - Fax:
Practice Address - Street 1:2 SOUTH STA
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-2208
Practice Address - Country:US
Practice Address - Phone:339-224-4745
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-24
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care