Provider Demographics
NPI:1932835022
Name:SERENITY HOME CARE AGENCY LLC
Entity Type:Organization
Organization Name:SERENITY HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:P/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:DERINNA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-229-1468
Mailing Address - Street 1:PO BOX 3383
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77588-3383
Mailing Address - Country:US
Mailing Address - Phone:832-229-1468
Mailing Address - Fax:
Practice Address - Street 1:159 RED OAK DR
Practice Address - Street 2:
Practice Address - City:MANVEL
Practice Address - State:TX
Practice Address - Zip Code:77578-4258
Practice Address - Country:US
Practice Address - Phone:832-229-1468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-29
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty