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General NPI Number Information
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NPI Number | 1346596541
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Entity Type | Organization
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Legal Business Name | SERENITY ADULT DAY CARE
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Dates
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Enumeration Date | 07/25/2012
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Last Update Date | 08/28/2012
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Provider Practice Location Address
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Address Line | 824 CROSS ST 1000 DOUGLAS ST
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City | CLEVELAND
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State | MS
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Zip | 38732-3906
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Country | US
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Telephone | 662-719-8603
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Fax |
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Provider Business Mailing Address
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Address Line | 824 CROSS ST
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City | CLEVELAND
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State | MS
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Zip | 38732-3906
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Country | US
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Telephone | 662-719-8603
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. TREVA EVANS GILES
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Credential |
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Telephone | 662-719-8603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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