Provider Demographics
NPI:1922406701
Name:SERENITY AND GRACE HOSPICE CARE, LLC
Entity Type:Organization
Organization Name:SERENITY AND GRACE HOSPICE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALTERNATE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:S
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-334-3542
Mailing Address - Street 1:919 GRANT PL
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-2313
Mailing Address - Country:US
Mailing Address - Phone:361-334-3542
Mailing Address - Fax:844-685-2273
Practice Address - Street 1:9241 S PADRE ISLAND DR STE B
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78418-5503
Practice Address - Country:US
Practice Address - Phone:956-212-3872
Practice Address - Fax:844-685-2273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-11
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based