Organization
SERENITY CARE AGENCY , LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SONNY PHAM (PRESIDENT)
(212) 786-2343
Entity
Organization
Contact information
Practice address
6087 MYRTLE AVE, RIDGEWOOD, NY 11385-5908
(718) 717-7426
Mailing address
6087 MYRTLE AVE, RIDGEWOOD, NY 11385-5908
(718) 717-7426
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
2500L001
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2500L001
LHCSA
—
Enumeration date
08/01/2018
Last updated
08/01/2018
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