MEDICARE: SERENE HOME CARE OF PASCO, 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	:	1538604269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENE HOME CARE OF PASCO, LLC

Provider Business Mailing Address
First Line	:	3802 EHRLICH RD
Second Line	:	SUITE 309A
City	:	TAMPA
State	:	FL
Zip	:	33624-2378
Country	:	US
Telephone Number	:	813-374-0268
Fax Number	:	813-252-6941

Provider Business Practice Location Address
First Line	:	6648 ROWAN RD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34653-2940
Country	:	US
Telephone Number	:	813-374-0268
Fax Number	:	813-252-6941

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JENNY SEGARRA
Credential	:
Telephone Number	:	813-374-0268

Provider Enumeration Date	:	01/04/2017
Last Update Date	:	01/04/2017

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