Provider Demographics
NPI:1538345079
Name:SERENITY HEALTHCARE, LLC
Entity type:Organization
Organization Name:SERENITY HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DESIGNATED MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:EDDINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-901-0262
Mailing Address - Street 1:620 FRANCIS ST
Mailing Address - Street 2:SUITE 222
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64501-1928
Mailing Address - Country:US
Mailing Address - Phone:816-901-0262
Mailing Address - Fax:816-232-5052
Practice Address - Street 1:620 FRANCIS ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64501-1928
Practice Address - Country:US
Practice Address - Phone:816-901-0262
Practice Address - Fax:816-279-0499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based