Healthcare Provider Details

I. General information

NPI: 1144147729
Provider Name (Legal Business Name): SERENETI KOVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2971 REXFORD ST
JACKSONVILLE FL
32254-4032
US

IV. Provider business mailing address

2971 REXFORD ST
JACKSONVILLE FL
32254-4032
US

V. Phone/Fax

Practice location:
  • Phone: 904-562-8770
  • Fax:
Mailing address:
  • Phone: 904-562-8770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: ALKALINGEE CHANNELLE
Title or Position: OWNER/PROVIDER
Credential: RRT
Phone: 904-562-8770