Provider Demographics
NPI:1508619107
Name:SERENITY SENIOR CARE
Entity Type:Organization
Organization Name:SERENITY SENIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-749-1384
Mailing Address - Street 1:346 WABASH MNR
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-2670
Mailing Address - Country:US
Mailing Address - Phone:314-749-1384
Mailing Address - Fax:
Practice Address - Street 1:346 WABASH MNR
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-2670
Practice Address - Country:US
Practice Address - Phone:314-749-1384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health