| Organization Name: | SWEET HOME SERENITY CARE, LLC. |
| NPI Number: | 1265811244 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WENDY TOOMBS (OWNER) |
| Mailing Address: | 13279 Kings Hwy Suite #1 King George |
| State: | VA US |
| Postal Code: | 224854303 |
| Phone Number: | 5403842273 |
| Fax Number: | 5406938258 |
| NPI Enumeration Date: | 05/24/2015 |
| NPI Last Update Date: | 02/29/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 385H00000X |
| License Number: | HCO161285 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Respite Care Facility |
| Taxonomy Classification: | Respite Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |