SERENITY PLACE FAMILY CARE GROUP HOME (NPI# 1992106496) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992106496 |
| Entity Type | Organization |
| Organization Name | SERENITY PLACE FAMILY CARE GROUP HOME |
| Practice Address |
2011 Carrington Dr Orlando FL 32807-5206 |
| Practice Telephone | 4079148731 |
| Mailing Telephone | 4079148731 |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2014-09-30 |
| Authorized Official Name | MISS CARMEL NATALIE GABRIEL (CERTIFIED NURSING ASSISTANT) |
| Authorized Official Telephone | 4079148731 |
| Authorized Official Credential | CNA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
FL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 010617200 | 05 |
| Street Address |
2011 CARRINGTON DR |
| City | ORLANDO |
| State | FL |
| Zip Code | 32807-5206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922668037 | Javier Urshela | Rehabilitation Counselor | 1150 S Semoran Blvd Suite A, Orlando, FL 32807 | 2019-06-20 |
| 1326602087 | Darnell Maurice Avent | Counselor | 7835 Pine Crossing Circle, Apt: 1038, Orlando, FL 32807 | 2019-04-29 |
| 1689185233 | Janea Mark | Technician/Technologist | 2242 Gator Drive, 326, Orlando, FL 32807 | 2017-10-22 |
| 1659813863 | Yaritza Joan Mattei Collado | Speech-Language Pathologist | 1136 Farwell, Orlando, FL 32807 | 2016-11-07 |
| 1316495815 | Grimarie Fernandez | Counselor | 1601 N. Goldenrod Rd. Suite 2, A Great Life, Inc, Orlando, FL 32807 | 2016-09-14 |
| 1922473958 | Adam Brett Lowery | Counselor | 1400 Semoran Blvd, Orlando, FL 32807 | 2015-12-02 |
| 1396115093 | Peterson Jean-baptiste | Counselor | 7835 Pine Crossing Circle, Apt. 1027, Orlando, FL 32807 | 2015-10-07 |
| 1396121380 | Sonia Vega | Case Management | 1601 N. Goldenrod Rd., Orlando, FL 32807 | 2015-08-03 |
| 1386036069 | Guidewell Emergency Medicine Doctors | Clinic/Center | 1706 N Semoran Blvd, Orlando, FL 32807 | 2015-03-04 |
| 1821339276 | Cac- Florida Medical Centers LLC | Clinic/Center | 737 South Semoran Blvd, Orlando, FL 32807 | 2013-03-11 |
| Find all providers in zip 32807 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114551884 | Christle Haven LLC | Custodial Care Facility | 2523 Leston Ct, Orlando, FL 32817-2614 | 2020-03-02 |
| 1942772520 | Angels of Jesus | Custodial Care Facility | 1404 N Observatory Dr, Orlando, FL 32818-5916 | 2018-12-20 |
| 1639678139 | Lise's Garden Afch, LLC | Custodial Care Facility | 1542 Providence Cir, Orlando, FL 32818-5708 | 2018-02-09 |
| 1821506585 | Have Faith Care Services | Custodial Care Facility | 927 S Goldwyn Ave Ste 117, Orlando, FL 32805-4389 | 2018-01-16 |
| 1144743733 | A Home With Tlc LLC | Custodial Care Facility | 4116 Lenox Blvd, Orlando, FL 32811-4134 | 2017-07-25 |
| 1659824357 | Marie Francois | Custodial Care Facility | 8655 Tarragon Dr, Orlando, FL 32825-3644 | 2016-07-28 |
| 1003288499 | Edith Bort | Custodial Care Facility | 227 Woodbury Pines Cir, Orlando, FL 32828-9086 | 2015-10-23 |
| 1386045813 | Hermina Jean | Custodial Care Facility | 3502 Londonberry Blvd, Orlando, FL 32808-3629 | 2014-09-16 |
| 1790192979 | Serenity Adult Family Care Home LLC | Custodial Care Facility | 748 Mellowood Ave, Orlando, FL 32825-8077 | 2014-07-19 |
| 1043645716 | Allheart Board and Care | Custodial Care Facility | 2668 Logandale Dr, Orlando, FL 32817-4722 | 2013-09-12 |
| Find all providers in ORLANDO | ||||
Please comment or provide details below to improve the information on SERENITY PLACE FAMILY CARE GROUP HOME.
| 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.