Provider Demographics
NPI:1578390886
Name:SERENITY CARE GROUP HOME LLC
Entity type:Organization
Organization Name:SERENITY CARE GROUP HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KHADI
Authorized Official - Middle Name:
Authorized Official - Last Name:TURAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-291-5201
Mailing Address - Street 1:2583 NORTHWOLD RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-5991
Mailing Address - Country:US
Mailing Address - Phone:240-291-5201
Mailing Address - Fax:
Practice Address - Street 1:2583 NORTHWOLD RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-5991
Practice Address - Country:US
Practice Address - Phone:240-291-5201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care