- Enrollment id
- O20070524000051
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1457485864
- Multiple npi flag
- N
- Ccn
- 679726
- Associate id
- 9133226277
- Organization name
- SERENITY HEALTHCARE SERVICES INC
- Incorporation date
- 2006-08-29
- Incorporation state
- TX
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 10701 CORPORATE DR
- Address line 2
- STE 336
- City
- STAFFORD
- State
- TX
- Zip code
- 774774017