Provider Demographics
NPI:1851726236
Name:SERENITY ACRES HOSPICE AND PALLIATIVE CARE SERVICES, INC
Entity Type:Organization
Organization Name:SERENITY ACRES HOSPICE AND PALLIATIVE CARE SERVICES, INC
Other - Org Name:SERENITY ACRES HOSPICE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/COO
Authorized Official - Prefix:MR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOGOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-213-7898
Mailing Address - Street 1:1555 E UNIVERSITY DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-8143
Mailing Address - Country:US
Mailing Address - Phone:480-213-7898
Mailing Address - Fax:480-203-2293
Practice Address - Street 1:1555 E UNIVERSITY DR
Practice Address - Street 2:SUITE 3
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-8143
Practice Address - Country:US
Practice Address - Phone:480-213-7898
Practice Address - Fax:480-203-2293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based