Healthcare Provider Details

I. General information

NPI: 1285412544
Provider Name (Legal Business Name): SERENE PATH HOME CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2023
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9111 CROSS PARK DR STE D200
KNOXVILLE TN
37923-4521
US

IV. Provider business mailing address

9111 CROSS PARK DR STE D200
KNOXVILLE TN
37923-4521
US

V. Phone/Fax

Practice location:
  • Phone: 865-315-8037
  • Fax: 865-910-0105
Mailing address:
  • Phone: 865-888-2807
  • Fax: 865-910-0105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TONYA FERGUSON
Title or Position: CEO
Credential:
Phone: 865-315-8037