Provider Demographics
NPI:1821675562
Name:SERENE SANCTUARY HOSPICE INC.
Entity Type:Organization
Organization Name:SERENE SANCTUARY HOSPICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DON/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:PLACENCIA
Authorized Official - Last Name:GUNDRY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:818-534-7254
Mailing Address - Street 1:14500 ROSCOE BLVD FL 4
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-4194
Mailing Address - Country:US
Mailing Address - Phone:818-485-1455
Mailing Address - Fax:323-372-3757
Practice Address - Street 1:14500 ROSCOE BLVD FL 4
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4194
Practice Address - Country:US
Practice Address - Phone:818-485-1455
Practice Address - Fax:323-372-3757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-27
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based