Organization Active NPI

Serene Home Care LLC

  • Home Health Agency
  • Black Jack, MO
National Provider Identifier
1902787005
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
SERENE HOME CARE LLC
Practice address
12315 Wensley Rd
Black Jack, MO 63033-7327
Phone
(240) 938-4090
NPI assigned
Sep 8, 2025
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Malaika Dorsey
Title
Owner
Phone
(240) 938-4090

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

12315 Wensley Rd
Black Jack, MO 63033-7327

Mailing address

12315 Wensley Rd
Black Jack, MO 63033-7327
Phone (240) 938-4090

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 8, 2025.

{
    "created_epoch": "1757289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757289600000",
    "number": "1902787005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12315 WENSLEY RD",
            "city": "BLACK JACK",
            "state": "MO",
            "postal_code": "630337327",
            "telephone_number": "240-938-4090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12315 WENSLEY RD",
            "city": "BLACK JACK",
            "state": "MO",
            "postal_code": "630337327",
            "telephone_number": "240-938-4090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENE HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-08",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A",
        "authorized_official_last_name": "DORSEY",
        "authorized_official_first_name": "MALAIKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-938-4090"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Black Jack, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.