Provider Demographics
NPI:1730914722
Name:SERENITY SAFE CARE WELLNESS FAMILY
Entity type:Organization
Organization Name:SERENITY SAFE CARE WELLNESS FAMILY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CNA
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-794-6811
Mailing Address - Street 1:120 BAILEY CT
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30215-7715
Mailing Address - Country:US
Mailing Address - Phone:248-794-6811
Mailing Address - Fax:
Practice Address - Street 1:120 BAILEY CT
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30215-7715
Practice Address - Country:US
Practice Address - Phone:248-794-6811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-07
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care