MEDICARE: SERENITY CARE SOLUTIONS 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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1457967176
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITY CARE SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	607 E WALLISVILLE RD
Second Line	:
City	:	HIGHLANDS
State	:	TX
Zip	:	77562-3831
Country	:	US
Telephone Number	:	732-484-6354
Fax Number	:

Provider Business Practice Location Address
First Line	:	607 E WALLISVILLE RD
Second Line	:
City	:	HIGHLANDS
State	:	TX
Zip	:	77562-3831
Country	:	US
Telephone Number	:	732-484-6354
Fax Number	:

Authorized Official
Title or Position	:	CEO / FOUNDER
Name	:	MISS MARY YOUSSIF
Credential	:	MBA
Telephone Number	:	732-484-6354

Provider Enumeration Date	:	09/17/2020
Last Update Date	:	09/17/2020

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