Provider Demographics
NPI:1649821240
Name:SERENITY PERSONAL CARE SERVICES LLC
Entity type:Organization
Organization Name:SERENITY PERSONAL CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:COURTNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-723-9049
Mailing Address - Street 1:PO BOX 752
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:AR
Mailing Address - Zip Code:71657-0752
Mailing Address - Country:US
Mailing Address - Phone:870-723-9040
Mailing Address - Fax:
Practice Address - Street 1:510 W GAINES ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:AR
Practice Address - Zip Code:71655-4638
Practice Address - Country:US
Practice Address - Phone:870-224-8051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-25
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty