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General NPI Number Information
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NPI Number | 1922415710
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Entity Type | Organization
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Legal Business Name | SERENITY HOSPICE OF CLAREMORE
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Dates
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Enumeration Date | 07/14/2014
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Last Update Date | 07/14/2014
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Provider Practice Location Address
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Address Line | 35904 S HIGHWAY 82
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City | VINITA
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State | OK
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Zip | 74301-6743
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Country | US
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Telephone | 918-782-1414
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Fax | 918-782-1415
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Provider Business Mailing Address
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Address Line | 35904 S HIGHWAY 82
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City | VINITA
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State | OK
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Zip | 74301-6743
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Country | US
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Telephone | 918-782-1414
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Fax | 918-782-1415
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANDY A RISMAN
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Credential |
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Telephone | 918-782-1414
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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 | 4246
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License Number State | OK
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