Healthcare Provider Details

I. General information

NPI: 1306759162
Provider Name (Legal Business Name): SERENITY HOMES AFH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3517 W BRUCE AVE
SPOKANE WA
99208-4642
US

IV. Provider business mailing address

3517 W BRUCE AVE
SPOKANE WA
99208-4642
US

V. Phone/Fax

Practice location:
  • Phone: 509-339-4059
  • Fax:
Mailing address:
  • Phone: 509-339-4059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: PATRICK LEKISHON NAIRIMO
Title or Position: PROVIDER
Credential: HCA
Phone: 509-339-4059