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General NPI Number Information
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NPI Number | 1871287292
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Entity Type | Organization
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Legal Business Name | SERENITEE CARE LLC
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Dates
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Enumeration Date | 06/07/2023
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 2620 OWEN DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28306-2933
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Country | US
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Telephone | 910-930-2718
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 53755
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City | FAYETTEVILLE
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State | NC
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Zip | 28305-3755
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Country | US
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Telephone | 910-930-2718
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Fax |
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Authorized Official
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Title or Position | CEO/DIRECTOR
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Name | RITA UDOH
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Credential |
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Telephone | 910-930-2718
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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 |
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Taxonomy #2
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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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