MEDICARE: A SERENA CARE HOSPICE, 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	:	1790189074
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A SERENA CARE HOSPICE, LLC

Provider Business Mailing Address
First Line	:	210 E HOUSTON ST
Second Line	:
City	:	CLEVELAND
State	:	TX
Zip	:	77327-4512
Country	:	US
Telephone Number	:	281-593-1500
Fax Number	:	281-593-1509

Provider Business Practice Location Address
First Line	:	210 E HOUSTON ST
Second Line	:
City	:	CLEVELAND
State	:	TX
Zip	:	77327-4512
Country	:	US
Telephone Number	:	281-593-1500
Fax Number	:	281-593-1509

Authorized Official
Title or Position	:	CEO
Name	:	DR. DUC (STEVE) M LE
Credential	:	M.D.
Telephone Number	:	281-593-1500

Provider Enumeration Date	:	10/15/2014
Last Update Date	:	10/22/2014

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