Organization
SERENITY COMPANION SERVICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAVETTE GULLEY (OWNER)
(352) 348-3509
Entity
Organization
Contact information
Practice address
116 S MAGNOLIA AVE, SUITE 3D, OCALA, FL 34471-1178
(352) 348-3509
(180) 037-2701
Mailing address
15 FIR TRAIL CRSE, OCALA, FL 34472-4220
(352) 348-3509
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
231201
FL
251S00000X
Community/Behavioral Health Agency
Primary
231201
FL
253Z00000X
In Home Supportive Care Agency
231201
FL
305R00000X
Preferred Provider Organization
231201
FL
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
231201
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000565902
—
FL
Enumeration date
06/10/2016
Last updated
01/04/2017
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