Provider Demographics
NPI:1699206235
Name:SERENITY OF MIND
Entity Type:Organization
Organization Name:SERENITY OF MIND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BEATRICE
Authorized Official - Middle Name:N
Authorized Official - Last Name:YUMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-751-1076
Mailing Address - Street 1:863 ASHTON COVE TER
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-3796
Mailing Address - Country:US
Mailing Address - Phone:904-751-1076
Mailing Address - Fax:
Practice Address - Street 1:863 ASHTON COVE TER
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-3796
Practice Address - Country:US
Practice Address - Phone:904-751-1076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-24
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care