Healthcare Provider Details

I. General information

NPI: 1326557000
Provider Name (Legal Business Name): SERENITY REHABILITATION AND HEALTH CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2017
Last Update Date: 02/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 SOUTHERN AVE SE
WASHINGTON DC
20032-4623
US

IV. Provider business mailing address

368 NEW HEMPSTEAD RD STE 309
NEW CITY NY
10956-1900
US

V. Phone/Fax

Practice location:
  • Phone: 202-279-5880
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: EFRAIM ROOZ
Title or Position: AUTHORIZED MEMBER
Credential:
Phone: 845-490-6060