Organization
SERENITY VILLAGE INC
Active
Other names
Serenity Village Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY T HARTFIELD (PRESIDENT)
(727) 452-8744
Entity
Organization
Contact information
Practice address
3420 S DALE MABRY HWY STE S, TAMPA, FL 33629-8660
(727) 648-4925
Mailing address
3420 S DALE MABRY HWY STE S, TAMPA, FL 33629-8660
(727) 648-4925
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
310400000X
Assisted Living Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
685663296
—
FL
Enumeration date
01/21/2022
Last updated
01/21/2022
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