Provider Type Icon

SERENITY HAVEN ADULT DAY CARE INC NPI 1912149626


NPI Information

NPI: 1912149626
Provider Name: SERENITY HAVEN ADULT DAY CARE INC
Classification: Licensed Practical Nurse - 164W00000X
Entity Type: Organization
Address:
1109 E 156TH ST
DOLTON, IL
ZIP 60419
Phone: (708) 476-3795
Get Directions

SERENITY HAVEN ADULT DAY CARE INC is a licensed practical nurse in Dolton, IL. The provider is a licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. SERENITY HAVEN ADULT DAY CARE INC NPI is 1912149626. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1109 E 156TH ST
DOLTON, IL
ZIP 60419-777
Phone: (708) 476-3795
Fax: (773) 821-0720

The provider's authorized official is Nikkita C Johnson- Neealy .
The authorized official title is Owner/nurse and has the following contact phone number (708) 476-3795.

The enumeration date for this NPI number is 3/26/2009 and was last updated on 5/1/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1164W00000XLicensed Practical Nurse043.087417ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.