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General NPI Number Information
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NPI Number | 1346725413
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Entity Type | Organization
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Legal Business Name | SERENITY LIFE COUNSELING CENTER LLC
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Dates
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Enumeration Date | 09/25/2018
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 804 N HOAGLAND BLVD
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City | KISSIMMEE
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State | FL
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Zip | 34741-4518
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Country | US
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Telephone | 407-797-7298
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Fax | 407-386-3201
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Provider Business Mailing Address
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Address Line | 111 N ORANGE AVE STE 800
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City | ORLANDO
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State | FL
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Zip | 32801-2381
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Country | US
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Telephone | 407-797-7298
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Fax | 407-386-3201
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Authorized Official
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Title or Position | CEO
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Name | OSWALDO JOSE PEREZ
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Credential | MH16250
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Telephone | 407-797-7298
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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