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General NPI Number Information
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NPI Number | 1992953384
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Entity Type | Organization
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Legal Business Name | SERENITY NURSING CARE INC
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Dates
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Enumeration Date | 08/28/2008
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Last Update Date | 08/28/2008
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Provider Practice Location Address
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Address Line | 10017 LAKE AVE #401
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City | CLEVELAND
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State | OH
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Zip | 44102-1282
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Country | US
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Telephone | 216-338-7783
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 671
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City | LAKEWOOD
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State | OH
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Zip | 44107-0971
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/NURSE
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Name | MISS CARMELINA S ENGLISH
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Credential | LPN
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Telephone | 216-338-7783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 120847
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License Number State | OH
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