Organization
SERENITY HOUSE ADULT DAY HEALTH SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHERINE RICHARDSON (PRESIDENT)
(601) 833-4166
Entity
Organization
Contact information
Practice address
511 N. CHURCH STREET, BROOKHAVEN, MS 39601-2709
(601) 833-4166
Mailing address
POST OFFICE BOX 1334, BROOKHAVEN, MS 39601
(601) 833-4166
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
887539
MS
261QA0600X
Adult Day Care Clinic/Center
Primary
887539
MS
343900000X
Non-emergency Medical Transport (VAN)
887539
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03680547
—
MS
Enumeration date
12/10/2007
Last updated
12/10/2007
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