Provider Demographics
NPI:1831990035
Name:A1 SERENITY HOSPICE, LLC
Entity type:Organization
Organization Name:A1 SERENITY HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOCKHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-686-0051
Mailing Address - Street 1:18163 W PUEBLO AVE
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-2042
Mailing Address - Country:US
Mailing Address - Phone:602-686-0051
Mailing Address - Fax:623-267-9789
Practice Address - Street 1:15610 N 35TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053-3838
Practice Address - Country:US
Practice Address - Phone:602-863-4179
Practice Address - Fax:623-267-9789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based