Provider Demographics
NPI:1548555063
Name:SERENITY HEALTHCARE GROUP, INC
Entity type:Organization
Organization Name:SERENITY HEALTHCARE GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:818-295-3800
Mailing Address - Street 1:1130 W OLIVE AVE
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-2214
Mailing Address - Country:US
Mailing Address - Phone:818-295-3800
Mailing Address - Fax:818-295-3801
Practice Address - Street 1:1130 W OLIVE AVE
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2214
Practice Address - Country:US
Practice Address - Phone:818-295-3800
Practice Address - Fax:818-295-3801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherEIN