Healthcare Provider Details

I. General information

NPI: 1154895860
Provider Name (Legal Business Name): SERENITY HEALTH CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2019
Last Update Date: 01/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 BROAD ST STE 1A
AUGUSTA GA
30901-7400
US

IV. Provider business mailing address

1827 MICKIE ANN WAY
HEPHZIBAH GA
30815-8931
US

V. Phone/Fax

Practice location:
  • Phone: 706-798-5354
  • Fax:
Mailing address:
  • Phone: 706-339-7062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: PAMELA D LOVETT
Title or Position: CEO
Credential:
Phone: 706-339-7062