MEDICARE: SERENITY HOME HEALTH CARE

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1861892069
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITY HOME HEALTH CARE

Provider Business Mailing Address
First Line	:	3800 POPLAR HILL ROAD
Second Line	:	SUITE D
City	:	CHESAPEAKE
State	:	VA
Zip	:	23321-5522
Country	:	US
Telephone Number	:	757-484-3000
Fax Number	:	866-586-3865

Provider Business Practice Location Address
First Line	:	3800 POPLAR HILL ROAD
Second Line	:	SUITE D
City	:	CHESAPEAKE
State	:	VA
Zip	:	23321-5522
Country	:	US
Telephone Number	:	757-484-3000
Fax Number	:	866-586-3865

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. JEANETTE WHITEHEAD
Credential	:
Telephone Number	:	757-484-3000

Provider Enumeration Date	:	08/26/2014
Last Update Date	:	08/26/2014

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