Provider Demographics
NPI:1417738303
Name:SERENITY SUPPORT CENTER
Entity Type:Organization
Organization Name:SERENITY SUPPORT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:SHARONA
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEAT
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:330-430-9017
Mailing Address - Street 1:2981 S ARLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-4717
Mailing Address - Country:US
Mailing Address - Phone:330-316-3021
Mailing Address - Fax:
Practice Address - Street 1:3746 MARTINDALE RD NE APT 6
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44714-1367
Practice Address - Country:US
Practice Address - Phone:330-430-9017
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty