Provider Demographics
NPI:1295510923
Name:SERENITY LIVING HOME CARE LLC
Entity type:Organization
Organization Name:SERENITY LIVING HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HEREDIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-219-8055
Mailing Address - Street 1:3927 BUTTERCUP CIR S
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-5670
Mailing Address - Country:US
Mailing Address - Phone:407-219-8055
Mailing Address - Fax:
Practice Address - Street 1:3927 BUTTERCUP CIR S
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-5670
Practice Address - Country:US
Practice Address - Phone:407-219-8055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility