Healthcare Provider Details

I. General information

NPI: 1073448437
Provider Name (Legal Business Name): SERENITY ADULT HOME CARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 RUSSELL ST
ORANGEBURG SC
29115-6053
US

IV. Provider business mailing address

1408 RUSSELL ST STE 14
ORANGEBURG SC
29115-6071
US

V. Phone/Fax

Practice location:
  • Phone: 803-290-6684
  • Fax:
Mailing address:
  • Phone: 803-290-6684
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name: FELICIA SHAREEF
Title or Position: OWNER
Credential: LPN
Phone: 803-290-6684