Healthcare Provider Details

I. General information

NPI: 1760373989
Provider Name (Legal Business Name): SERENITY COMFORT CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2025
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

399 GIBSON SAWMILL RD
HAVANA FL
32333-3309
US

IV. Provider business mailing address

PO BOX 1286
HAVANA FL
32333-1298
US

V. Phone/Fax

Practice location:
  • Phone: 850-399-8246
  • Fax:
Mailing address:
  • Phone: 850-399-8246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: SHONKERIA MITCHELL
Title or Position: MANAGING MEMBER
Credential:
Phone: 850-399-8246