Healthcare Provider Details
I. General information
NPI: 1730464033
Provider Name (Legal Business Name): SERENITY CARE HOSPICE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/18/2011
Last Update Date: 11/02/2022
Certification Date: 11/02/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
811 WESTCHESTER AVE
HARRISONVILLE MO
64701-1784
US
IV. Provider business mailing address
811 WESTCHESTER AVE
HARRISONVILLE MO
64701-1784
US
V. Phone/Fax
- Phone: 816-380-3913
- Fax: 816-380-3912
- Phone: 816-380-3913
- Fax: 816-380-3912
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WH1000X |
| Taxonomy | Hospice Registered Nurse |
| License Number | |
| License Number State | MO |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HEATH
BARTNESS
Title or Position: CEO
Credential:
Phone: 651-328-6914