Provider Demographics
NPI:1760724066
Name:SERENITY HOME HEALTH SERVICES
Entity type:Organization
Organization Name:SERENITY HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:908-925-1990
Mailing Address - Street 1:11 ANDERSON CT
Mailing Address - Street 2:
Mailing Address - City:SAYREVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08872-1000
Mailing Address - Country:US
Mailing Address - Phone:732-387-0240
Mailing Address - Fax:
Practice Address - Street 1:218 N WOOD AVE
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-4217
Practice Address - Country:US
Practice Address - Phone:908-925-1990
Practice Address - Fax:908-925-1968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-25
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1578767190Medicaid