Healthcare Provider Details

I. General information

NPI: 1568630879
Provider Name (Legal Business Name): SERENITY HEALTH CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2008
Last Update Date: 12/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 OAKLEY SEAVER DR
CLERMONT FL
34711-1968
US

IV. Provider business mailing address

835 OAKLEY SEAVER DR
CLERMONT FL
34711-1968
US

V. Phone/Fax

Practice location:
  • Phone: 352-241-9282
  • Fax: 352-241-4282
Mailing address:
  • Phone: 352-241-9282
  • Fax: 352-241-4282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PRITHA RAJESHWORI DHUNGANA
Title or Position: OWNER
Credential: M.D.
Phone: 352-241-9282