Provider Demographics
NPI:1124819586
Name:SERENITY LIFE HOME CARE L.L.C
Entity type:Organization
Organization Name:SERENITY LIFE HOME CARE L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:DESHONA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-858-6199
Mailing Address - Street 1:850 EUCLID AVE STE 819
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114-3315
Mailing Address - Country:US
Mailing Address - Phone:216-858-6199
Mailing Address - Fax:
Practice Address - Street 1:850 EUCLID AVE STE 819
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-3315
Practice Address - Country:US
Practice Address - Phone:216-858-6199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty