Provider Demographics
NPI:1639515992
Name:SERENITY CANDLES & SOAPS, INC.
Entity Type:Organization
Organization Name:SERENITY CANDLES & SOAPS, INC.
Other - Org Name:JEN'S HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:VERNON
Authorized Official - Middle Name:B
Authorized Official - Last Name:BUCKMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-733-6004
Mailing Address - Street 1:1872 CHEDWORTH LN
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-2121
Mailing Address - Country:US
Mailing Address - Phone:770-733-6004
Mailing Address - Fax:
Practice Address - Street 1:1872 CHEDWORTH LN
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-2121
Practice Address - Country:US
Practice Address - Phone:770-733-6004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health