Healthcare Provider Details

I. General information

NPI: 1417681685
Provider Name (Legal Business Name): SERENITY SQUARE OF NEW ORLEANS CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2022
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2475 CANAL ST STE 101
NEW ORLEANS LA
70119-6571
US

IV. Provider business mailing address

1353 SURREY ST
LAFAYETTE LA
70501-7617
US

V. Phone/Fax

Practice location:
  • Phone: 504-234-7777
  • Fax: 504-582-9294
Mailing address:
  • Phone: 337-345-4444
  • Fax: 337-266-5893

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name: ROBERT CAILLIER
Title or Position: MANAGER
Credential:
Phone: 337-704-7777