Provider Demographics
NPI:1922774504
Name:SERENITY COMMUNITY MENTAL HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:SERENITY COMMUNITY MENTAL HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YADIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-534-8366
Mailing Address - Street 1:4160 N ARMENIA AVE STE A
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6453
Mailing Address - Country:US
Mailing Address - Phone:786-534-8366
Mailing Address - Fax:
Practice Address - Street 1:4160 N ARMENIA AVE STE A
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6453
Practice Address - Country:US
Practice Address - Phone:786-534-8366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SERENITY COMMUNITY MENTAL HEALTH CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
786-534-8366OtherPHONE NUMBER