MEDICARE: SERENE TRAILS THERAPY LLC

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	1041C0700X	Clinical Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1417506429	OTHER		NPI 1

General Provider Information

NPI Number	:	1548890825
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENE TRAILS THERAPY LLC

Provider Business Mailing Address
First Line	:	6803 LAKE WORTH RD STE 215
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33467-2979
Country	:	US
Telephone Number	:	561-335-6658
Fax Number	:

Provider Business Practice Location Address
First Line	:	6803 LAKE WORTH RD STE 215
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33467-2979
Country	:	US
Telephone Number	:	561-335-6658
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BRITTANY RICE
Credential	:	LCSW
Telephone Number	:	561-335-6658

Provider Enumeration Date	:	01/25/2020
Last Update Date	:	09/30/2024

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