Provider Demographics
NPI:1437657921
Name:GENUINELY SERENE SENIOR HOMECARE
Entity type:Organization
Organization Name:GENUINELY SERENE SENIOR HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHYVONNE
Authorized Official - Middle Name:SENIOR
Authorized Official - Last Name:HOLBROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-579-0102
Mailing Address - Street 1:3273 HINKLE DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37218-3140
Mailing Address - Country:US
Mailing Address - Phone:615-579-0102
Mailing Address - Fax:
Practice Address - Street 1:3273 HINKLE DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37218-3140
Practice Address - Country:US
Practice Address - Phone:615-579-0102
Practice Address - Fax:615-678-1977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-30
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN=========OtherSENIOR HOMECARE