SERENITY HOUSE AFCH NPI 1205277407

NPI Information

NPI: 1205277407
Provider Name: SERENITY HOUSE AFCH

Other Name: CAMILLA BRIDGEMAN

Classification: Residential Treatment Facility, Physical Disabilities - 320700000X
Entity Type: Organization
Address:
943 62ND TER S
ST PETERSBURG, FL
ZIP 33705
Phone: (727) 906-9405
Get Directions

SERENITY HOUSE AFCH is a residential treatment facility physical disabilities in St Petersburg, FL. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently. SERENITY HOUSE AFCH NPI is 1205277407. The provider is registered as an organization entity type.
The provider Other Name Is Camilla Bridgeman.

The provider's business location address is:

943 62ND TER S
ST PETERSBURG, FL
ZIP 33705-818
Phone: (727) 906-9405
Fax: (727) 906-9405

The provider's authorized official is Camilla Lee Bridgeman .
The authorized official title is Owner and has the following contact phone number (727) 906-9405.

The enumeration date for this NPI number is 7/16/2013 and was last updated on 7/16/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320700000X	Residential Treatment Facility, Physical Disabilities		6906590	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	5766SPICES	MEDICAID	FLORIDA
2	VACATION51	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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