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General NPI Number Information
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NPI Number | 1013298744
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Entity Type | Organization
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Legal Business Name | SERENITY CARE, INC,
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Dates
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Enumeration Date | 09/08/2011
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Last Update Date | 09/08/2011
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Provider Practice Location Address
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Address Line | 223 JONES DR
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City | BRIDGEVILLE
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State | PA
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Zip | 15017-1933
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Country | US
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Telephone | 412-628-6866
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Fax |
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Provider Business Mailing Address
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Address Line | 223 JONES DR
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City | BRIDGEVILLE
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State | PA
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Zip | 15017-1933
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Country | US
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Telephone | 412-628-6866
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | KELLY ZERRLAUT
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Credential | MPACJ
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Telephone | 412-628-6866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 434360
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License Number State | PA
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