Healthcare Provider Details

I. General information

NPI: 1356141279
Provider Name (Legal Business Name): SERENITY SENIOR COMPANION CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2025
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5524 S VENTURA DR
OKLAHOMA CITY OK
73135-5416
US

IV. Provider business mailing address

PO BOX 55811
OKLAHOMA CITY OK
73155-0811
US

V. Phone/Fax

Practice location:
  • Phone: 405-627-8552
  • Fax: 405-455-1215
Mailing address:
  • Phone: 405-627-8552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: EVONNDA JEAN FIELEDS
Title or Position: CEO
Credential: MSW
Phone: 405-474-4669