Healthcare Provider Details
I. General information
NPI: 1205467735
Provider Name (Legal Business Name): SERENDIPITY CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/03/2020
Last Update Date: 07/14/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11901 BUSINESS BLVD STE 1-2
EAGLE RIVER AK
99577-7701
US
IV. Provider business mailing address
11901 BUSINESS BLVD STE 202
EAGLE RIVER AK
99577-7701
US
V. Phone/Fax
- Phone: 907-313-2300
- Fax: 907-313-2301
- Phone: 907-313-2300
- Fax: 907-313-2301
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTINE
TEEL
Title or Position: MEMBER/BRANCH MANAGER
Credential:
Phone: 79-313-2300