Provider Demographics
NPI:1922370998
Name:SERENITY HOSPICE LLC
Entity Type:Organization
Organization Name:SERENITY HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-330-9699
Mailing Address - Street 1:7033 N KEDZIE AVE
Mailing Address - Street 2:701
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-2845
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7033 N KEDZIE AVE
Practice Address - Street 2:701
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-2845
Practice Address - Country:US
Practice Address - Phone:773-330-9699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based