Healthcare Provider Details

I. General information

NPI: 1447174149
Provider Name (Legal Business Name): THE SERENITY STARS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 HALL ST
PROVIDENCE RI
02904-2405
US

IV. Provider business mailing address

81 HALL ST
PROVIDENCE RI
02904-2405
US

V. Phone/Fax

Practice location:
  • Phone: 401-572-4920
  • Fax:
Mailing address:
  • Phone: 401-572-4930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MATILDA FOLARIN ADEYEMI
Title or Position: DIRECTOR
Credential:
Phone: 401-572-4930