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Organization

SERENITY RESIDENTIAL HOME CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TIMOTHY LEE SHOALS SR. BS (OWNER)
(405) 361-7643
Entity
Organization

Contact information

Practice address
1129 N HARVARD AVE, OKLAHOMA CITY, OK 73127-4021
(405) 946-3341
(405) 272-1630
Mailing address
214 SW 30TH ST, OKLAHOMA CITY, OK 73109-6506
(405) 361-7643
(405) 272-1630

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary

Other

Enumeration date
04/28/2016
Last updated
04/28/2016
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