Provider Demographics
NPI:1013298744
Name:SERENITY CARE, INC,
Entity Type:Organization
Organization Name:SERENITY CARE, INC,
Other - Org Name:SERENITY PINES PERSONAL CARE HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZERRLAUT
Authorized Official - Suffix:
Authorized Official - Credentials:MPACJ
Authorized Official - Phone:412-628-6866
Mailing Address - Street 1:223 JONES DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-1933
Mailing Address - Country:US
Mailing Address - Phone:412-628-6866
Mailing Address - Fax:
Practice Address - Street 1:223 JONES DR
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-1933
Practice Address - Country:US
Practice Address - Phone:412-628-6866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA434360310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility