Provider Demographics
NPI:1336521418
Name:SERENITY RG SERVICES. INC.
Entity Type:Organization
Organization Name:SERENITY RG SERVICES. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:I
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:RBT / CNA / HHA
Authorized Official - Phone:305-640-5739
Mailing Address - Street 1:6447 MIAMI LAKES DR STE 206
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2762
Mailing Address - Country:US
Mailing Address - Phone:305-640-5739
Mailing Address - Fax:305-640-5698
Practice Address - Street 1:7065 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-5205
Practice Address - Country:US
Practice Address - Phone:305-640-5739
Practice Address - Fax:305-640-5698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-24
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL15694200Medicaid
FL020106000Medicaid
FL13606800Medicaid