Provider Demographics
NPI:1700525441
Name:SERENITY ALLIANCE HC INC
Entity Type:Organization
Organization Name:SERENITY ALLIANCE HC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:K
Authorized Official - Last Name:FANKAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-641-6043
Mailing Address - Street 1:3346 YELLOW FLOWER RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-3200
Mailing Address - Country:US
Mailing Address - Phone:240-476-7440
Mailing Address - Fax:
Practice Address - Street 1:3346 YELLOW FLOWER RD
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20724-3200
Practice Address - Country:US
Practice Address - Phone:240-476-7440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care