Healthcare Provider Details

I. General information

NPI: 1184498404
Provider Name (Legal Business Name): SERENITY SISTERS HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2023
Last Update Date: 06/29/2025
Certification Date: 06/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 E MIDLOTHIAN BLVD STE B
YOUNGSTOWN OH
44502-2569
US

IV. Provider business mailing address

715 E MIDLOTHIAN BLVD STE B
YOUNGSTOWN OH
44502-2569
US

V. Phone/Fax

Practice location:
  • Phone: 234-228-9554
  • Fax:
Mailing address:
  • Phone: 330-314-2815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name: NAKEISHA TALTOAN
Title or Position: AGENCY PROVIDER
Credential:
Phone: 330-314-2815