MEDICARE: SERENITY HEALTH & SUPPORTED LIVING

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	:	1437017035
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITY HEALTH & SUPPORTED LIVING

Provider Business Mailing Address
First Line	:	9723 109TH STREET CT SW
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98498-3059
Country	:	US
Telephone Number	:	404-388-2333
Fax Number	:	253-342-4713

Provider Business Practice Location Address
First Line	:	9723 109TH STREET CT SW
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98498-3059
Country	:	US
Telephone Number	:	404-388-2333
Fax Number	:	253-342-4713

Authorized Official
Title or Position	:	CEO/ADMINISTRATOR
Name	:	SHNARIKA POWELL
Credential	:
Telephone Number	:	404-388-2333

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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