Provider Demographics
NPI:1316172174
Name:SERENITY FALLS HOME HEALTH AGENCY, INC.
Entity type:Organization
Organization Name:SERENITY FALLS HOME HEALTH AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CFO
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA OKPADILE
Authorized Official - Middle Name:OBIANUJU
Authorized Official - Last Name:OKPADILE
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:682-553-4112
Mailing Address - Street 1:4928 SCREECH OWL LN
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-3059
Mailing Address - Country:US
Mailing Address - Phone:682-553-4112
Mailing Address - Fax:972-206-2321
Practice Address - Street 1:4928 SCREECH OWL LN
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-3059
Practice Address - Country:US
Practice Address - Phone:682-553-4112
Practice Address - Fax:972-206-2321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-22
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health