Provider Demographics
NPI:1902373749
Name:SERENITY ASSISTED CARE LIVING, L.L.C.
Entity type:Organization
Organization Name:SERENITY ASSISTED CARE LIVING, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSELYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:VERTIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-299-5855
Mailing Address - Street 1:1945 PENNSYLVANIA ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-6025
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1945 PENNSYLVANIA ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-6025
Practice Address - Country:US
Practice Address - Phone:409-299-5855
Practice Address - Fax:409-291-8555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-30
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No385H00000XRespite Care FacilityRespite Care