# SERENITY RESIDENTIAL SERVICES INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912494246
- **Authorized official:** MRS. LAUREN ASHLEE THOMAS (VICE PRESIDENT)
- **Authorized official phone:** (904) 379-8914

## Contact information

- **Practice address:** 2406 UNIVERSITY BLVD W, JACKSONVILLE, FL 32217-2002
- **Practice address phone:** (904) 379-8914
- **Practice address fax:** (904) 800-1465
- **Mailing address:** 2406 UNIVERSITY BLVD W, JACKSONVILLE, FL 32217-2002
- **Mailing address phone:** (904) 379-8914
- **Mailing address fax:** (904) 800-1465

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103K00000X | Behavior Analyst | — | FL | — |
| 106S00000X | Behavior Technician | — | NULL | — |
| 106S00000X | Behavior Technician | — | — | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | FL | Yes |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | — | NULL | — |
| 385HR2060X | Child Intellectual and/or Developmental Disabilities Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 04/23/2018
- **Last updated:** 04/23/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 010423200 | — | FL |