Provider Demographics
NPI:1043182389
Name:ANGELS OF SERENITY HOME CARE INCORPORATED
Entity type:Organization
Organization Name:ANGELS OF SERENITY HOME CARE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:BALLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-200-1216
Mailing Address - Street 1:4620 E 53RD ST STE 200
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-3627
Mailing Address - Country:US
Mailing Address - Phone:563-200-1216
Mailing Address - Fax:563-265-5425
Practice Address - Street 1:4620 E 53RD ST STE 221
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-3620
Practice Address - Country:US
Practice Address - Phone:563-200-1216
Practice Address - Fax:563-265-5425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care