MEDICARE: SERENITY HOME HEALTH AGENCY

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251J00000X	Nursing Care Agency
2	251B00000X	Case Management Agency
3	261QD1600X	Developmental Disabilities Clinic/Center
4	343900000X	Non-emergency Medical Transport (VAN)
5	374U00000X	Home Health Aide
6	385H00000X	Respite Care
7	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1528863057
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITY HOME HEALTH AGENCY

Provider Business Mailing Address
First Line	:	8442 S US HIGHWAY 1
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952-3306
Country	:	US
Telephone Number	:	772-252-6543
Fax Number	:	772-266-2835

Provider Business Practice Location Address
First Line	:	8442 S US HIGHWAY 1
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952-3306
Country	:	US
Telephone Number	:	772-252-6543
Fax Number	:	772-266-2835

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JASMINE NOEL
Credential	:
Telephone Number	:	772-867-2278

Provider Enumeration Date	:	02/18/2025
Last Update Date	:	02/18/2025

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Directions to “SERENITY HOME HEALTH AGENCY ” Practice Location

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