Provider Demographics
NPI:1700303591
Name:SERENITY HOME CARE & SERVICES
Entity Type:Organization
Organization Name:SERENITY HOME CARE & SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DIRECTOR/FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:GEMMA
Authorized Official - Middle Name:P
Authorized Official - Last Name:VEGA
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:740-971-9901
Mailing Address - Street 1:P.O. BOX 1603
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:34786
Mailing Address - Country:US
Mailing Address - Phone:802-328-1970
Mailing Address - Fax:407-601-0325
Practice Address - Street 1:2301 LAKE DEBRA DRIVE APT 112
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835
Practice Address - Country:US
Practice Address - Phone:740-971-9901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-23
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372600000X, 374U00000X, 376J00000X
FLCNA348786376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty