MEDICARE: SAFE HAVEN SERENITY CARE 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
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1235066739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAFE HAVEN SERENITY CARE LLC

Provider Business Mailing Address
First Line	:	610 YORK ST
Second Line	:
City	:	CAMDEN
State	:	SC
Zip	:	29020-4640
Country	:	US
Telephone Number	:	803-677-3185
Fax Number	:

Provider Business Practice Location Address
First Line	:	610 YORK ST
Second Line	:
City	:	CAMDEN
State	:	SC
Zip	:	29020-4640
Country	:	US
Telephone Number	:	803-677-3185
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	MRS. ROCHELLE WARREN-COUNCIL
Credential	:
Telephone Number	:	803-549-0155

Provider Enumeration Date	:	05/07/2026
Last Update Date	:	05/07/2026

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