| Organization Name: | SERENECARE INC |
| NPI Number: | 1225433931 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LISA KELLER (LPN) |
| Mailing Address: | 4905 S 107th Ave Ste 205 Omaha |
| State: | NE US |
| Postal Code: | 681271965 |
| Phone Number: | 4025972585 |
| Fax Number: | 4025972644 |
| NPI Enumeration Date: | 10/24/2014 |
| NPI Last Update Date: | 10/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | 18698 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |