Organization
SERENITY SQUARE LLC
Active
Other names
Ageless Independence Center
Organization subpart
No
Provider details
NPI number
Authorized official
GWENDOLYN CAILLIER (ADMINISTRATOR)
(337) 654-5519
Entity
Organization
Contact information
Practice address
1011 SURREY ST, LAFAYETTE, LA 70501-6142
(337) 456-4873
(337) 266-5893
Mailing address
500 SURREY ST, LAFAYETTE, LA 70501-6134
(337) 266-5892
(337) 266-5893
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
15006-B
LA
Other
Enumeration date
07/19/2013
Last updated
07/19/2013
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