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General NPI Number Information
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NPI Number | 1740752914
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Entity Type | Organization
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Legal Business Name | SERENITY HEALTHCARE, LLC
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Dates
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Enumeration Date | 12/27/2018
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Last Update Date | 12/27/2018
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Provider Practice Location Address
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Address Line | 32145 ALVARADO NILES RD
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City | UNION CITY
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State | CA
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Zip | 94587-2930
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Country | US
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Telephone | 510-972-0305
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Fax |
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Provider Business Mailing Address
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Address Line | 32145 ALVARADO NILES RD
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City | UNION CITY
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State | CA
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Zip | 94587-2930
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Country | US
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Telephone | 510-972-0305
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | GLADYS G WILLIAMS
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Credential |
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Telephone | 510-972-0305
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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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