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General NPI Number Information
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NPI Number | 1003098856
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Entity Type | Organization
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Legal Business Name | SERENITY HOSPICE LLC
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Dates
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Enumeration Date | 12/04/2007
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Last Update Date | 01/27/2012
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Provider Practice Location Address
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Address Line | 777 E TAHQUITZ CANYON WAY SUITE 301-308
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City | PALM SPRINGS
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State | CA
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Zip | 92262-6784
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Country | US
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Telephone | 760-325-8718
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Fax | 760-325-8739
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Provider Business Mailing Address
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Address Line | 777 E TAHQUITZ CANYON WAY SUITE 301-308
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City | PALM SPRINGS
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State | CA
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Zip | 92262-6784
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Country | US
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Telephone | 760-325-8718
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Fax | 760-325-8739
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | PETER L. GO
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Credential | RN
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Telephone | 760-325-8718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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