Healthcare Provider Details

I. General information

NPI: 1063343358
Provider Name (Legal Business Name): THE SEASONED RELAXATION CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 N JEFFERSON ST UNIT 805
MONTICELLO FL
32344-2164
US

IV. Provider business mailing address

2612 NEZ PERCE TRL
TALLAHASSEE FL
32303-2144
US

V. Phone/Fax

Practice location:
  • Phone: 850-443-0316
  • Fax: 448-220-4186
Mailing address:
  • Phone: 850-443-0316
  • Fax: 448-220-4186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name: TREVEKA DIONNE SMITH
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 850-443-0316