Provider Demographics
NPI:1316304926
Name:SERENITY CARE SOLUTIOS
Entity type:Organization
Organization Name:SERENITY CARE SOLUTIOS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-428-6816
Mailing Address - Street 1:2637 E ATLANTIC BLVD
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-4939
Mailing Address - Country:US
Mailing Address - Phone:404-428-6816
Mailing Address - Fax:
Practice Address - Street 1:2637 E ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-4939
Practice Address - Country:US
Practice Address - Phone:404-428-6816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-27
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherCOMMERICAL INSURANCE