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General NPI Number Information
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NPI Number | 1801713276
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Entity Type | Organization
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Legal Business Name | SERENITY HOME SUPPORT
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Dates
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Enumeration Date | 07/06/2026
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Last Update Date | 07/06/2026
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Provider Practice Location Address
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Address Line | 5725 OLEANDER DR STE F2
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City | WILMINGTON
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State | NC
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Zip | 28403-4747
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Country | US
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Telephone | 910-399-2298
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Fax |
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Provider Business Mailing Address
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Address Line | 5725 OLEANDER DR STE F2
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City | WILMINGTON
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State | NC
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Zip | 28403-4747
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Country | US
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Telephone | 910-399-2298
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. SCOTT DAVID CISLO
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Credential | CSA
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Telephone | 518-848-0738
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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