Healthcare Provider Details

I. General information

NPI: 1669326476
Provider Name (Legal Business Name): SI-RENE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 W OWNSBY PKWY APT 4110
CELINA TX
75009-3625
US

IV. Provider business mailing address

505 W OWNSBY PKWY APT 4110
CELINA TX
75009-3625
US

V. Phone/Fax

Practice location:
  • Phone: 430-280-1162
  • Fax:
Mailing address:
  • Phone: 430-280-1162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: CHANCELIER AYEMELE MAKENG
Title or Position: ADMINISTRATOR
Credential:
Phone: 430-280-1162