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General NPI Number Information
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NPI Number | 1174491641
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Entity Type | Organization
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Legal Business Name | SIMPLY SERENITY HEALTHCARE AGENCY LLC
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Dates
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Enumeration Date | 10/27/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 16741 TERREBONNE DR
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City | TYLER
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State | TX
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Zip | 75703-7785
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Country | US
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Telephone | 469-335-3387
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Fax | 877-681-0459
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Provider Business Mailing Address
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Address Line | 16741 TERREBONNE DR
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City | TYLER
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State | TX
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Zip | 75703-7785
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Country | US
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Telephone | 469-335-3387
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Fax | 877-681-0459
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | SANDRA WILLIAMS
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Credential |
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Telephone | 469-335-3387
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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