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General NPI Number Information
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NPI Number | 1487213336
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Entity Type | Organization
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Legal Business Name | SERENITY SENIOR CARE,INC
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Dates
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Enumeration Date | 06/12/2019
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Last Update Date | 06/12/2019
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Provider Practice Location Address
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Address Line | 126 N CEDAR AVE
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City | HIGHLAND SPRINGS
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State | VA
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Zip | 23075-1429
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Country | US
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Telephone | 804-999-1719
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Fax |
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Provider Business Mailing Address
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Address Line | 126 N CEDAR AVE
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City | HIGHLAND SPRINGS
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State | VA
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Zip | 23075-1429
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Country | US
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Telephone | 804-999-1719
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DESIREE LANCASTER-BUSSEY
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Credential |
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Telephone | 804-999-1719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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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 | 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 #3
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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