Provider Demographics
NPI:1194262188
Name:SULTANI SERENITY HOME HEALTH CARE AGENCY, LLC
Entity type:Organization
Organization Name:SULTANI SERENITY HOME HEALTH CARE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NAHIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SULTANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-929-3994
Mailing Address - Street 1:7306 BONNIEMILL LN
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-4439
Mailing Address - Country:US
Mailing Address - Phone:703-866-7829
Mailing Address - Fax:
Practice Address - Street 1:7306 BONNIEMILL LN
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-4439
Practice Address - Country:US
Practice Address - Phone:703-866-7829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-27
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health