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General NPI Number Information
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NPI Number | 1578614046
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Entity Type | Organization
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Legal Business Name | SERENITY LIVING, LLC
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Dates
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Enumeration Date | 01/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4106 DUTCH MILL RD
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-4438
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Country | US
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Telephone | 410-922-1772
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Fax |
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Provider Business Mailing Address
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Address Line | 6818 PARSONS AVE
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City | GWYNN OAK
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State | MD
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Zip | 21207-6422
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Country | US
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Telephone | 410-484-3649
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LINDA ASTWOOD
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Credential |
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Telephone | 410-922-1772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | R2321
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License Number State | MD
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