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General NPI Number Information
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NPI Number | 1407255391
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Entity Type | Organization
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Legal Business Name | SERENE TRANSFORMATION CENTER LLC
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Dates
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Enumeration Date | 08/18/2014
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Last Update Date | 09/29/2014
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Provider Practice Location Address
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Address Line | 5449 S SEMORAN BLVD SUITE 237
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City | ORLANDO
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State | FL
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Zip | 32822-1722
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Country | US
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Telephone | 407-375-5339
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Fax | 877-991-2620
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Provider Business Mailing Address
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Address Line | 5449 S SEMORAN BLVD SUITE 237
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City | ORLANDO
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State | FL
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Zip | 32822-1722
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Country | US
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Telephone | 407-375-5339
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. NATALIE HEWITT
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Credential | LCSW
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Telephone | 407-375-5339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | SW 12106
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License Number State | FL
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