SERENITY HOUSE AFCH (NPI# 1205277407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205277407 |
| Entity Type | Organization |
| Organization Name | SERENITY HOUSE AFCH |
| Other Organization Name | CAMILLA BRIDGEMAN |
| Practice Address |
943 62nd Ter S St Petersburg FL 33705-5818 |
| Mailing Address |
943 62nd Terrace S. St. Petersburg USA 33705 UM |
| Practice Telephone | 7279069405 |
| Practice Fax Number | 7279069405 |
| Mailing Telephone | 7279069405 |
| Mailing Fax Number | 7279069405 |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2013-07-16 |
| Authorized Official Name | MRS. CAMILLA LEE BRIDGEMAN (OWNER) |
| Authorized Official Telephone | 7279069405 |
| Authorized Official Credential | PCT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320700000X | Residential Treatment Facility, Physical Disabilities | 6906590 | FL | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 5766SPICES | 05 | |
| FL | VACATION51 | 05 |
| Other Name | Type Code |
|---|---|
| Camilla Bridgeman | Other Name - Individual/Organization |
| Street Address |
943 62ND TER S |
| City | ST PETERSBURG |
| State | FL |
| Zip Code | 33705-5818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935781 | Caressa Alice Slocum | Psychologist | 840 Dr M.l.k. Jr St N, St. Petersburg, FL 33705 | 2020-09-01 |
| 1386133015 | Angela Ann Little | Social Worker | 920 Country Club Way S, St Petersburg, FL 33705 | 2018-05-08 |
| 1497279483 | Infinity Health Consultants, LLC. | In Home Supportive Care | 1001 27th Avenue South, St. Petersburg, FL 33705 | 2017-08-01 |
| 1801320528 | Dedicated Senior Medical Center St. Petersburg, LLC. | Non-Pharmacy Dispensing Site | 901 22nd Avenue South, Dedicated Senior Medical Center St. Petersburg, LLC., St. Petersburg, FL 33705 | 2017-04-19 |
| 1790135762 | Robin Dong | Emergency Medicine | 1095 5th Ave N, St. Petersburg, FL 33705 | 2016-06-20 |
| 1437550084 | Community Health Center of Pinellas Inc | Clinic/Center | 612 Dr Martin L King St N, St Petersburg, FL 33705 | 2014-09-12 |
| 1164851754 | Jennifer Carey | Counselor | 11 Mlk Jr St South, St. Petersburg, FL 33705 | 2013-11-05 |
| 1750623997 | Dannaly Reyes Baerga | Physical Medicine & Rehabilitation | 1201 5th Ave N Ste 202, St Petersburg, FL 33705 | 2013-03-26 |
| 1518209055 | Nii Sai Torto | Emergency Medicine | 500 Doctor. M.l.k, Jr. Street North, Ste 303, Saint Petersburg, FL 33705 | 2013-03-22 |
| 1790034635 | Melissa White Kidwell | Physical Therapist | 500 Mlking Street N, Ste 100, St. Petersburg, FL 33705 | 2012-09-06 |
| Find all providers in zip 33705 | ||||
| Taxonomy Code | 320700000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Physical Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538782271 | Cordell & Associates LLC | Residential Treatment Facility, Physical Disabilities | 2921 Swoop Cir, Kissimmee, FL 34741-7838 | 2020-05-27 |
| 1427688597 | Lashena Jackson | Residential Treatment Facility, Physical Disabilities | 5677 Chirping Way W, Jacksonville, FL 32222-2310 | 2020-01-17 |
| 1518478353 | Derwin T Callahan | Residential Treatment Facility, Physical Disabilities | 113 Bethune St, Lake Placid, FL 33852-5698 | 2017-10-19 |
| 1346759115 | Speedway Plus 2 Car Care Center LLCc | Residential Treatment Facility, Physical Disabilities | 8007 Glenoak Rd., Tampa, FL 33610 | 2017-09-25 |
| 1700300092 | Martinez Group Home, LLC | Residential Treatment Facility, Physical Disabilities | 14918 Sw 15 Ln, Miami, FL 33194 | 2017-07-28 |
| 1962935452 | Sharyn Trapp | Residential Treatment Facility, Physical Disabilities | 1820 N Westmoreland Dr, Orlando, FL 32804-5738 | 2017-04-11 |
| 1942741921 | Endeavor Swallowing Solutions | Residential Treatment Facility, Physical Disabilities | 8826 Shell Island Dr, Jacksonville, FL 32216-4706 | 2017-03-10 |
| 1366993404 | Steve Ewald | Residential Treatment Facility, Physical Disabilities | 5595 Willoughby Dr, Melbourne, FL 32934-2822 | 2016-10-24 |
| 1518413921 | Las Delicias Alf #2 | Residential Treatment Facility, Physical Disabilities | 3840 Nw 184th St, Miami Gardens, FL 33055-2835 | 2016-08-27 |
| 1780137455 | Axiom | Residential Treatment Facility, Physical Disabilities | 2400 River Tree Cir, Sanford, FL 32771-8332 | 2016-07-29 |
| Find all providers with the same taxonomy | ||||
| City | ST PETERSBURG |
| Zip Code | 33705 |
Please comment or provide details below to improve the information on SERENITY HOUSE AFCH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.