Organization
SERENITY RANCH ASSISTED LIVING HOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LU ANN SAMUELSON ADMINASTRATIVE (OWNER)
(954) 533-9184
Entity
Organization
Contact information
Practice address
12475 SW 58TH ST, SOUTHWEST RANCHES, FL 33330-3201
(954) 533-9184
(954) 763-2162
Mailing address
12475 SW 58TH ST, SOUTHWEST RANCHES, FL 33330-3201
(954) 533-9184
(954) 763-2162
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
AL11718
FL
Other
Enumeration date
04/05/2012
Last updated
04/05/2012
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