Provider Demographics
NPI:1750723284
Name:SERENITY HOME HEALTH OF SOMERSET
Entity type:Organization
Organization Name:SERENITY HOME HEALTH OF SOMERSET
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEVELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-918-8118
Mailing Address - Street 1:132 PREWITT PLACE DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-5470
Mailing Address - Country:US
Mailing Address - Phone:404-918-8118
Mailing Address - Fax:
Practice Address - Street 1:132 PREWITT PLACE DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-5470
Practice Address - Country:US
Practice Address - Phone:404-918-8118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-25
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health