Organization
SERENITYS WAY
Active
Organization
SERENITYS WAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MILDRED E ILER LPN (CEO)
13302719817
Entity
Organization
Contact information
Practice address
11557 STATE ROUTE 45, LISBON, OH 44432-8621
(330) 271-9817
Mailing address
11557 STATE ROUTE 45, LISBON, OH 44432-8621
(330) 271-9338
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
7609010
OH
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0114960
—
OH
Enumeration date
09/08/2016
Last updated
10/06/2016
Update your record
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