Provider Demographics
NPI:1639745037
Name:SERENITY LOVE AND HOPE MINISTRIES INC
Entity Type:Organization
Organization Name:SERENITY LOVE AND HOPE MINISTRIES INC
Other - Org Name:SERENITY HEALTH NETWORK MEDICAL CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TOCOVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHIPPLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN MSN BEHAVIORAL
Authorized Official - Phone:786-508-3181
Mailing Address - Street 1:6475 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4843
Mailing Address - Country:US
Mailing Address - Phone:786-492-9978
Mailing Address - Fax:
Practice Address - Street 1:6475 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4843
Practice Address - Country:US
Practice Address - Phone:786-492-9978
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-27
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL12766330OtherDUNS NUMBER