Organization
SERENITY HOUSE AFCH
Active
Other names
Camilla Bridgeman
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAMILLA LEE BRIDGEMAN PCT (OWNER)
(727) 906-9405
Entity
Organization
Contact information
Practice address
943 62ND TER S, ST PETERSBURG, FL 33705-5818
(727) 906-9405
(727) 906-9405
Mailing address
943 62ND TERRACE S., ST. PETERSBURG, USA 33705
(727) 906-9405
(727) 906-9405
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
6906590
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5766SPICES
—
FL
05
—
VACATION51
—
FL
Enumeration date
07/16/2013
Last updated
07/16/2013
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