Provider Demographics
NPI:1033988738
Name:SERENITY WAY HOUSING
Entity Type:Organization
Organization Name:SERENITY WAY HOUSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LIZA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-600-6325
Mailing Address - Street 1:2424 W. BRANDON BLVD. #1207
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511
Mailing Address - Country:US
Mailing Address - Phone:313-600-6325
Mailing Address - Fax:
Practice Address - Street 1:5025 BRICKWOOD RISE DRIVE
Practice Address - Street 2:
Practice Address - City:WIMAUMA
Practice Address - State:FL
Practice Address - Zip Code:33598
Practice Address - Country:US
Practice Address - Phone:313-600-6325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care