Healthcare Provider Details

I. General information

NPI: 1336061183
Provider Name (Legal Business Name): SERENA HOME HEALTHCARE L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20627 GLENMERE SQ
STERLING VA
20165-3563
US

IV. Provider business mailing address

20627 GLENMERE SQ
STERLING VA
20165-3563
US

V. Phone/Fax

Practice location:
  • Phone: 703-488-8984
  • Fax:
Mailing address:
  • Phone: 703-488-8984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DUAA IDAIS
Title or Position: OWNER
Credential:
Phone: 703-488-8984