Provider Demographics
NPI:1457141269
Name:BETHEL SERENITY CARE INC
Entity type:Organization
Organization Name:BETHEL SERENITY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEQUITA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-296-2676
Mailing Address - Street 1:6000 POPLAR AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-3974
Mailing Address - Country:US
Mailing Address - Phone:901-296-2676
Mailing Address - Fax:
Practice Address - Street 1:6000 POPLAR AVE STE 250
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3974
Practice Address - Country:US
Practice Address - Phone:901-296-2676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based