Organization
SERENITYHOMECARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHAUNENA IRENE STAPLE (PCA)
(601) 942-9401
Entity
Organization
Contact information
Practice address
1512 CLINTON RAYMOND RD, CLINTON, MS 39056-5400
(601) 942-9401
Mailing address
1512 CLINTON RAYMOND RD, CLINTON, MS 39056-5400
(601) 942-9401
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
DOMO5355
MS
Other
Enumeration date
05/07/2015
Last updated
05/07/2015
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