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General NPI Number Information
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NPI Number | 1740464841
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Entity Type | Organization
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Legal Business Name | SERENITY HOME HEALTH
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Dates
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Enumeration Date | 12/26/2007
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Last Update Date | 12/26/2007
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Provider Practice Location Address
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Address Line | 2139 W MANCHESTER BLVD
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City | INGLEWOOD
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State | CA
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Zip | 90301
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Country | US
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Telephone | 323-440-8033
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Fax |
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Provider Business Mailing Address
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Address Line | 414 W 99TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90003-3919
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Country | US
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Telephone | 323-440-8033
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Fax |
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Authorized Official
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Title or Position | SOLE OWNER
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Name | MS. WENDELL CHEVELL WALKER
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Credential |
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Telephone | 323-440-8033
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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 | CA
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