Healthcare Provider Details

I. General information

NPI: 1619636735
Provider Name (Legal Business Name): SENIOR SERENITY HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2021
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 EASTCHESTER RD
BRONX NY
10469-3202
US

IV. Provider business mailing address

3000 EASTCHESTER RD
BRONX NY
10469-3202
US

V. Phone/Fax

Practice location:
  • Phone: 917-742-8285
  • Fax:
Mailing address:
  • Phone: 917-742-8285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHAKEVA BROWN-NNAJI
Title or Position: CEO
Credential: SONOGRAPHER
Phone: 917-742-8285