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General NPI Number Information
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NPI Number | 1568065902
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Entity Type | Organization
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Legal Business Name | SERENITY HOME HEALTH CARE, LLC
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Dates
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Enumeration Date | 11/18/2020
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Last Update Date | 02/17/2022
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Provider Practice Location Address
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Address Line | 3622 LYCKAN PKWY STE 4007
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City | DURHAM
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State | NC
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Zip | 27707-2566
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Country | US
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Telephone | 919-748-3694
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Fax | 919-748-3722
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Provider Business Mailing Address
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Address Line | 3622 LYCKAN PKWY STE 4007
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City | DURHAM
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State | NC
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Zip | 27707-2566
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Country | US
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Telephone | 919-748-3694
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Fax | 919-748-3722
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Authorized Official
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Title or Position | OWNER
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Name | EVELEAN SIMMS
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Credential | OWNER
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Telephone | 919-519-1405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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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 #3
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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