Provider Demographics
NPI:1902438336
Name:SERENITY COMMUNITY CARE
Entity Type:Organization
Organization Name:SERENITY COMMUNITY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LANISHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CHA
Authorized Official - Phone:567-702-1259
Mailing Address - Street 1:4203 PIEDMONT DR
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-6552
Mailing Address - Country:US
Mailing Address - Phone:567-702-1259
Mailing Address - Fax:866-548-0674
Practice Address - Street 1:4203 PIEDMONT DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-6552
Practice Address - Country:US
Practice Address - Phone:567-702-1259
Practice Address - Fax:866-548-0674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health