MEDICARE: SERENITY FAMILY HOMECARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1225797061
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITY FAMILY HOMECARE LLC

Provider Business Mailing Address
First Line	:	1210 CENTRAL BLVD STE 116
Second Line	:
City	:	BRENTWOOD
State	:	CA
Zip	:	94513-2360
Country	:	US
Telephone Number	:	925-766-7292
Fax Number	:	877-509-5344

Provider Business Practice Location Address
First Line	:	1210 CENTRAL BLVD STE 116
Second Line	:
City	:	BRENTWOOD
State	:	CA
Zip	:	94513-2360
Country	:	US
Telephone Number	:	925-766-7292
Fax Number	:	877-509-5344

Authorized Official
Title or Position	:	CEO
Name	:	MRS. LOVE LAH
Credential	:	RT(R)
Telephone Number	:	925-766-7292

Provider Enumeration Date	:	12/09/2021
Last Update Date	:	10/06/2025

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