Provider Demographics
NPI:1962682385
Name:SERENITY HOME HEALTH
Entity type:Organization
Organization Name:SERENITY HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:HUBERT
Authorized Official - Last Name:PANDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-499-9863
Mailing Address - Street 1:5302 PENINSULA WAY
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043
Mailing Address - Country:US
Mailing Address - Phone:972-499-9863
Mailing Address - Fax:972-546-0938
Practice Address - Street 1:5302 PENINSULA WAY
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043
Practice Address - Country:US
Practice Address - Phone:972-499-9863
Practice Address - Fax:972-546-0938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health