MEDICARE: SERENITY LIFE ADULT DAY CARE CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center
2	261QA0600X	Adult Day Care Clinic/Center	9347	FL

General Provider Information

NPI Number	:	1023435492
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITY LIFE ADULT DAY CARE CENTER INC

Provider Business Mailing Address
First Line	:	5625 W WATERS AVE STE G
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-1226
Country	:	US
Telephone Number	:	813-888-1200
Fax Number	:	813-882-4830

Provider Business Practice Location Address
First Line	:	5625 W WATERS AVE STE G
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-1226
Country	:	US
Telephone Number	:	813-888-1200
Fax Number	:	813-882-4830

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	YVONNE WONG
Credential	:
Telephone Number	:	813-888-1200

Provider Enumeration Date	:	03/24/2014
Last Update Date	:	07/21/2022

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