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General NPI Number Information
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NPI Number | 1134732910
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Entity Type | Organization
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Legal Business Name | SERENITY LOVE AND CARE LLC
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Dates
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Enumeration Date | 08/31/2020
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Last Update Date | 08/31/2020
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Provider Practice Location Address
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Address Line | 1105 JORDAN PARK ST S
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City | ST PETERSBURG
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State | FL
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Zip | 33712-2126
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Country | US
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Telephone | 727-611-8906
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 15076
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City | ST PETERSBURG
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State | FL
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Zip | 33733-5076
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHARELL ALLEN
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Credential |
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Telephone | 727-906-7388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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