Healthcare Provider Details

I. General information

NPI: 1437072006
Provider Name (Legal Business Name): SERENE BLOOM HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 LAKEMONT DR
GLEN BURNIE MD
21060-8792
US

IV. Provider business mailing address

610 LAKEMONT DR
GLEN BURNIE MD
21060-8792
US

V. Phone/Fax

Practice location:
  • Phone: 347-200-3955
  • Fax:
Mailing address:
  • Phone: 347-200-3955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MAYLANA WHITAKER
Title or Position: CO-OWNER
Credential:
Phone: 347-200-3955