Healthcare Provider Details

I. General information

NPI: 1790927804
Provider Name (Legal Business Name): SERENITY LIFE DBA COMFORT KEEPERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2009
Last Update Date: 04/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 W CHERRY LN
MERIDIAN ID
83642-1242
US

IV. Provider business mailing address

2150 W CHERRY LN
MERIDIAN ID
83642-1242
US

V. Phone/Fax

Practice location:
  • Phone: 208-895-8822
  • Fax: 208-884-4116
Mailing address:
  • Phone: 208-895-8822
  • Fax: 208-884-4116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. TERESA MEEKS
Title or Position: VICE PRESIDENT
Credential:
Phone: 208-895-8822