Provider Demographics
NPI:1093071995
Name:SERENITYS NEST RTC INC.
Entity Type:Organization
Organization Name:SERENITYS NEST RTC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSALYN
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:JORDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-578-2574
Mailing Address - Street 1:PO BOX 725
Mailing Address - Street 2:
Mailing Address - City:BROOKSHIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77423-0725
Mailing Address - Country:US
Mailing Address - Phone:832-578-2574
Mailing Address - Fax:
Practice Address - Street 1:4822 GASSNER RD.
Practice Address - Street 2:
Practice Address - City:BROOKSHIRE
Practice Address - State:TX
Practice Address - Zip Code:77423
Practice Address - Country:US
Practice Address - Phone:832-578-2574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No347C00000XTransportation ServicesPrivate Vehicle
No385H00000XRespite Care FacilityRespite Care