Healthcare Provider Details

I. General information

NPI: 1447137955
Provider Name (Legal Business Name): SERENE HOME HEALTH AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 REGAL RIDGE DR
INDEPENDENCE KY
41051-9350
US

IV. Provider business mailing address

909 REGAL RIDGE DR
INDEPENDENCE KY
41051-9350
US

V. Phone/Fax

Practice location:
  • Phone: 513-815-2512
  • Fax:
Mailing address:
  • Phone: 513-815-2512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JALYN LANAE WILLIAMS
Title or Position: ADMINISTRATOR
Credential: STNA
Phone: 513-815-2512