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General NPI Number Information
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NPI Number | 1902460843
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Entity Type | Organization
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Legal Business Name | SERENITY COMFORT CARE & FAMILY SERVICES
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Dates
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Enumeration Date | 04/25/2019
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Last Update Date | 04/25/2019
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Provider Practice Location Address
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Address Line | 226 BEACH 98TH ST # 3
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City | ROCKAWAY PARK
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State | NY
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Zip | 11694-2849
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Country | US
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Telephone | 718-569-0508
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Fax | 833-318-2368
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Provider Business Mailing Address
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Address Line | 226 BEACH 98TH ST # 3
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City | ROCKAWAY PARK
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State | NY
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Zip | 11694-2849
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Country | US
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Telephone | 718-569-0508
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Fax | 833-318-2368
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Authorized Official
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Title or Position | OWNER
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Name | KIMBERLY L JENKINS I
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Credential | HOME HEALTH CARE
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Telephone | 718-559-0508
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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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