Provider Demographics
NPI:1588128227
Name:SERENITY SPECIALTY COMPANIONS, LLC
Entity type:Organization
Organization Name:SERENITY SPECIALTY COMPANIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:CAROLINE
Authorized Official - Last Name:HUTCHINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-901-9701
Mailing Address - Street 1:411 MANCHESTER AVENUE
Mailing Address - Street 2:#108
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-3816
Mailing Address - Country:US
Mailing Address - Phone:215-901-9701
Mailing Address - Fax:215-893-4744
Practice Address - Street 1:411 MANCHESTER AVENUE
Practice Address - Street 2:#108
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-3816
Practice Address - Country:US
Practice Address - Phone:215-901-9701
Practice Address - Fax:215-893-4744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-28
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health