Provider Demographics
NPI:1922616192
Name:SERENDIPITY PRIVATE DUTY & RESPITE HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:SERENDIPITY PRIVATE DUTY & RESPITE HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:CHERRY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:248-505-8649
Mailing Address - Street 1:30997 PENDLETON APT 241
Mailing Address - Street 2:
Mailing Address - City:NEW HUDSON
Mailing Address - State:MI
Mailing Address - Zip Code:48165-9459
Mailing Address - Country:US
Mailing Address - Phone:248-505-8649
Mailing Address - Fax:
Practice Address - Street 1:30997 PENDLETON APT 241
Practice Address - Street 2:
Practice Address - City:NEW HUDSON
Practice Address - State:MI
Practice Address - Zip Code:48165-9459
Practice Address - Country:US
Practice Address - Phone:248-505-8649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care