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General NPI Number Information
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NPI Number | 1760062798
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Entity Type | Organization
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Legal Business Name | MY SERENITY HOME HEALTH SERVICES
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Dates
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Enumeration Date | 04/13/2021
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Last Update Date | 04/13/2021
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Provider Practice Location Address
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Address Line | 2606 MARTIN LUTHER KING JR BLVD STE 203
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City | DALLAS
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State | TX
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Zip | 75215-6329
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Country | US
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Telephone | 866-606-1273
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Fax |
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Provider Business Mailing Address
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Address Line | 200 N STATE ST UNIT 314
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City | LANCASTER
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State | TX
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Zip | 75146-2556
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Country | US
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Telephone | 214-962-0809
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHAWN BODLEY
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Credential |
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Telephone | 214-962-0809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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