Provider Demographics
NPI:1720338122
Name:SERENITY HOSPICE INC
Entity Type:Organization
Organization Name:SERENITY HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUZANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:TATEVOSYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-793-5666
Mailing Address - Street 1:2820 CAMINO DOS RIOS
Mailing Address - Street 2:SUITE B
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91320-1136
Mailing Address - Country:US
Mailing Address - Phone:818-793-5666
Mailing Address - Fax:818-475-5471
Practice Address - Street 1:2820 CAMINO DOS RIOS
Practice Address - Street 2:SUITE B
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91320-1136
Practice Address - Country:US
Practice Address - Phone:818-793-5666
Practice Address - Fax:818-475-5471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-12
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based