Provider Demographics
NPI:1831990142
Name:SERENITY LIFE HOME CARE AGENCY LLC
Entity type:Organization
Organization Name:SERENITY LIFE HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VERNISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:AVANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-468-0341
Mailing Address - Street 1:609 N MAIN ST STE 305
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:SC
Mailing Address - Zip Code:29571-3033
Mailing Address - Country:US
Mailing Address - Phone:843-468-0341
Mailing Address - Fax:
Practice Address - Street 1:609 N MAIN ST STE 305
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:SC
Practice Address - Zip Code:29571-3033
Practice Address - Country:US
Practice Address - Phone:843-468-0341
Practice Address - Fax:843-468-0341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-22
Last Update Date:2025-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
No251J00000XAgenciesNursing Care
No332U00000XSuppliersHome Delivered Meals