Provider Demographics
NPI:1770033342
Name:SERENITY BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:SERENITY BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SALVATORE
Authorized Official - Middle Name:
Authorized Official - Last Name:PALERMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-367-7944
Mailing Address - Street 1:2303 HOLLYWOOD BLVD
Mailing Address - Street 2:SUITE 12
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-6711
Mailing Address - Country:US
Mailing Address - Phone:954-367-7944
Mailing Address - Fax:954-374-8311
Practice Address - Street 1:2303 HOLLYWOOD BLVD
Practice Address - Street 2:SUITE 12
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-6711
Practice Address - Country:US
Practice Address - Phone:954-367-7944
Practice Address - Fax:954-374-8311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site