Healthcare Provider Details

I. General information

NPI: 1114024221
Provider Name (Legal Business Name): SERENITY HOSPICE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 S MULBERRY AVE
BUTLER AL
36904-2526
US

IV. Provider business mailing address

206 S MULBERRY AVE
BUTLER AL
36904-2526
US

V. Phone/Fax

Practice location:
  • Phone: 205-459-4080
  • Fax: 205-459-4090
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number011633
License Number StateAL

VIII. Authorized Official

Name: KAREN DAREE BRELAND
Title or Position: ADMINISTRATIVE DIRECTOR
Credential:
Phone: 601-663-4126