Provider Demographics
NPI:1013710888
Name:BIELDA SERENITY MAISON
Entity type:Organization
Organization Name:BIELDA SERENITY MAISON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AUGUSTE
Authorized Official - Middle Name:SEVERIN
Authorized Official - Last Name:BADIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-220-9493
Mailing Address - Street 1:865 LAKE ROYAL DR
Mailing Address - Street 2:
Mailing Address - City:GROVETOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30813-4515
Mailing Address - Country:US
Mailing Address - Phone:808-220-9493
Mailing Address - Fax:
Practice Address - Street 1:141 N BELAIR RD
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-3336
Practice Address - Country:US
Practice Address - Phone:808-220-9493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-28
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care