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General NPI Number Information
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NPI Number | 1043182389
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Entity Type | Organization
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Legal Business Name | ANGELS OF SERENITY HOME CARE INCORPORATED
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Dates
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Enumeration Date | 09/18/2025
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 4620 E 53RD ST STE 221
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City | DAVENPORT
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State | IA
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Zip | 52807-3620
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Country | US
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Telephone | 563-200-1216
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Fax | 563-265-5425
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Provider Business Mailing Address
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Address Line | 4620 E 53RD ST STE 200
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City | DAVENPORT
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State | IA
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Zip | 52807-3627
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Country | US
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Telephone | 563-200-1216
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Fax | 563-265-5425
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Authorized Official
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Title or Position | ADMINSTRATOR
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Name | MS. BROOKE BALLARD
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Credential |
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Telephone | 563-200-1216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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