Healthcare Provider Details

I. General information

NPI: 1114752367
Provider Name (Legal Business Name): SERENITY HOME HEALTHCARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2024
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4409 EXPEDITION DR
OAK POINT TX
75068-2088
US

IV. Provider business mailing address

4409 EXPEDITION DR
OAK POINT TX
75068-2088
US

V. Phone/Fax

Practice location:
  • Phone: 682-307-9939
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: KELECHI JENNIFER IKWUEGBU
Title or Position: HEALTH ADMINISTRATOR
Credential:
Phone: 682-307-9939