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NPI Code Detail

MEDICARE: SERENITY SQUARE LLC

MEDICARE: SERENITY SQUARE 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
1253Z00000XIn Home Supportive Care Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275726093
Entity Type Code : Organization
Provider Name (Legal Business Name) : SERENITY SQUARE LLC
Provider Business Mailing Address
First Line : 1353 SURREY ST
Second Line :
City : LAFAYETTE
State : LA
Zip : 70501-7617
Country : US
Telephone Number : 337-266-5892
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 : 337-266-5892
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : ROBERT A CAILLIER
Credential :
Telephone Number : 337-266-5892
Provider Enumeration Date : 08/24/2007
Last Update Date : 06/03/2025

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Directions to “SERENITY SQUARE LLC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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