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Organization
SERENITY RESIDENTIAL SERVICES INC
Active
Organization
SERENITY RESIDENTIAL SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAUREN ASHLEE THOMAS (VICE PRESIDENT)
(904) 379-8914
Entity
Organization
Contact information
Practice address
2406 UNIVERSITY BLVD W, JACKSONVILLE, FL 32217-2002
(904) 379-8914
(904) 800-1465
Mailing address
2406 UNIVERSITY BLVD W, JACKSONVILLE, FL 32217-2002
(904) 379-8914
(904) 800-1465
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
FL
106S00000X
Behavior Technician
—
NULL
106S00000X
Behavior Technician
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
FL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
NULL
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010423200
—
FL
Enumeration date
04/23/2018
Last updated
04/23/2018
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