- Enrollment id
- O20111108000643
- Enrollment state
- NJ
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1538451034
- Multiple npi flag
- N
- Ccn
- 311574
- Associate id
- 5092988089
- Organization name
- SERENITY HOSPICE CARE, LLC
- Incorporation date
- 2011-03-30
- Incorporation state
- NJ
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 56 GEORGETOWN RD
- City
- BORDENTOWN
- State
- NJ
- Zip code
- 085052405