Healthcare Provider Details

I. General information

NPI: 1548627425
Provider Name (Legal Business Name): SERENITY HOME HEALTH LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2016
Last Update Date: 01/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 E MAIN ST
WHITE SULPHUR SPRINGS MT
59645-9000
US

IV. Provider business mailing address

PO BOX 946
WHITE SULPHUR SPRINGS MT
59645-0946
US

V. Phone/Fax

Practice location:
  • Phone: 406-439-6904
  • Fax: 866-267-2440
Mailing address:
  • Phone: 406-439-6904
  • Fax: 866-267-2440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberRN-31772
License Number StateMT

VIII. Authorized Official

Name: LEANNE MARIE BODELL
Title or Position: MANAGING PARTNER
Credential:
Phone: 406-439-6904