Provider Demographics
NPI:1154751261
Name:SERENITY TREE SERVICES LLC
Entity type:Organization
Organization Name:SERENITY TREE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:SHARONDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:REESE
Authorized Official - Suffix:
Authorized Official - Credentials:BBA
Authorized Official - Phone:234-458-2002
Mailing Address - Street 1:1348 WOODLAND AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44703-1848
Mailing Address - Country:US
Mailing Address - Phone:234-258-5153
Mailing Address - Fax:330-576-5918
Practice Address - Street 1:4445 20TH ST NW STE A
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-2160
Practice Address - Country:US
Practice Address - Phone:234-458-2002
Practice Address - Fax:330-576-5918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-26
Last Update Date:2022-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No347C00000XTransportation ServicesPrivate Vehicle
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child