Provider Demographics
NPI:1013767169
Name:JEAN'S SERENITY STUDIO CO.
Entity Type:Organization
Organization Name:JEAN'S SERENITY STUDIO CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:DECARLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-257-4229
Mailing Address - Street 1:5133 W GIRARD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-4403
Mailing Address - Country:US
Mailing Address - Phone:267-257-4229
Mailing Address - Fax:
Practice Address - Street 1:5133 W GIRARD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-4403
Practice Address - Country:US
Practice Address - Phone:267-257-4229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty