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NPI Code Detail

MEDICARE: SERENITY SQUARE OF CENTRAL LA LLC

MEDICARE: SERENITY SQUARE OF CENTRAL LA LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1093670432
Entity Type Code : Organization
Provider Name (Legal Business Name) : SERENITY SQUARE OF CENTRAL LA LLC
Provider Business Mailing Address
First Line : 1353 SURREY ST
Second Line :
City : LAFAYETTE
State : LA
Zip : 70501-7617
Country : US
Telephone Number : 337-704-7777
Fax Number :
Provider Business Practice Location Address
First Line : 1353 SURREY ST
Second Line :
City : LAFAYETTE
State : LA
Zip : 70501-7617
Country : US
Telephone Number : 337-704-7777
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : ROBERT A CAILLIER
Credential :
Telephone Number : 337-704-7777
Provider Enumeration Date : 12/18/2025
Last Update Date : 12/18/2025

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Directions to “SERENITY SQUARE OF CENTRAL LA LLC ” Practice Location

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