Provider Demographics
NPI:1912694704
Name:SERENE HOME HEALTH CARE, LLC.
Entity Type:Organization
Organization Name:SERENE HOME HEALTH CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EVETTA
Authorized Official - Middle Name:I
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:252-536-8960
Mailing Address - Street 1:709 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-2515
Mailing Address - Country:US
Mailing Address - Phone:252-536-8960
Mailing Address - Fax:
Practice Address - Street 1:709 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-2515
Practice Address - Country:US
Practice Address - Phone:252-536-8960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care