Provider Demographics
NPI:1033570288
Name:TRUE GEM ENTERPRISES, LLC
Entity Type:Organization
Organization Name:TRUE GEM ENTERPRISES, LLC
Other - Org Name:SERENITY HOMECARE NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:LASHAUN
Authorized Official - Last Name:DELANCY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-678-1203
Mailing Address - Street 1:2174 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209-5815
Mailing Address - Country:US
Mailing Address - Phone:800-678-1203
Mailing Address - Fax:
Practice Address - Street 1:2174 W 10TH ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-5815
Practice Address - Country:US
Practice Address - Phone:800-678-1203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-16
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL120026800Medicaid