Provider Demographics
NPI:1598576050
Name:SERENCARE
Entity type:Organization
Organization Name:SERENCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-884-5613
Mailing Address - Street 1:1745 PHOENIX BLVD STE 300-335
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-5591
Mailing Address - Country:US
Mailing Address - Phone:929-884-5613
Mailing Address - Fax:
Practice Address - Street 1:410 PEACHTREE PKWY STE 4245
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-7407
Practice Address - Country:US
Practice Address - Phone:929-884-5613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health