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General NPI Number Information
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NPI Number | 1326867243
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Entity Type | Organization
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Legal Business Name | ANGELS OF SERENITY HOME CARE LLC
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Dates
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Enumeration Date | 10/08/2024
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 4620 E 53RD ST SUITE 200
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City | DAVENPORT
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State | IA
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Zip | 52807
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Country | US
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Telephone | 877-523-6160
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Fax |
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Provider Business Mailing Address
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Address Line | 4620 E 53RD ST SUITE 200
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City | DAVENPORT
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State | IA
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Zip | 52807
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Country | US
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Telephone | 877-523-6160
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Fax |
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Authorized Official
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Title or Position | CEO/CLINICAL DIRECTOR
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Name | KEZIA MCLEMORE
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Credential | RN
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Telephone | 877-523-6160
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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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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care 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 | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #5
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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 #6
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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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