Healthcare Provider Details

I. General information

NPI: 1912878695
Provider Name (Legal Business Name): SPRINGS SERENITY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 CITADEL DR E STE 453
COLORADO SPRINGS CO
80909-5314
US

IV. Provider business mailing address

685 CITADEL DR E STE 453
COLORADO SPRINGS CO
80909-5314
US

V. Phone/Fax

Practice location:
  • Phone: 612-261-6069
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: RIDWAN ALI
Title or Position: OWNER
Credential: ADMIN
Phone: 510-307-6630