SERENITY CHOICE PLACE, LLC (NPI# 1467835900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467835900 |
| Entity Type | Organization |
| Organization Name | SERENITY CHOICE PLACE, LLC |
| Practice Address |
721 Balmoral Circle Leesburg FL 34748 |
| Practice Telephone | 3213962427 |
| Mailing Telephone | 3213962427 |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | PEBBLES CARSON (OWNER/ MANAGER) |
| Authorized Official Telephone | 3213962427 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 253J00000X | Foster Care Agency | Agencies | ||
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 216 Afton Sq, Unit 309, Altamonte Springs, FL 327143842 | 7044508529 | |
| 721 Balmoral Cir, Leesburg, FL 347485606 | 7044508529 |
| Street Address |
721 BALMORAL CIRCLE |
| City | LEESBURG |
| State | FL |
| Zip Code | 34748 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437610243 | Ashley Shamsa Martin | Behavior Technician | 292 Bent Oak Ct, Leesburg, FL 34748 | 2019-03-26 |
| 1891278875 | Luis O Aponte Mendoza | Physician Assistant | 704 Doctors Ct., Suite 101, Leesburg, FL 34748 | 2018-09-14 |
| 1881197903 | Physician Associates LLC | Internal Medicine | 22316 Us Highway 27, Leesburg, FL 34748 | 2018-03-15 |
| 1184136145 | Infinite Support Services LLC | In Home Supportive Care | 129 Grove Ridge Circle, 104, Leesburg, FL 34748 | 2017-10-31 |
| 1619403037 | Massage and Wellness Care | Health Maintenance Organization | 1218 W. Dixie Ave, Suite A, Leesburg, FL 34748 | 2017-05-04 |
| 1497202675 | Prime Radiology of Leesburg Inc | Radiology | 600 N W Blvd, Suite E, Leesburg, FL 34748 | 2016-09-06 |
| 1023480332 | Juanita Elizabeth Simpson | Contractor | 1911 Harcourt Drive, Leesburg, FL 34748 | 2015-10-26 |
| 1356738397 | Touching Heart's Group Homes, LLC | Community/Behavioral Health | 31809 Sunpark Cir, Leesburg, FL 34748 | 2015-04-16 |
| 1386035269 | Adventist Health System/sunbelt, Inc. | Clinic/Center | 1103 N 14th Street, Leesburg, FL 34748 | 2015-02-12 |
| 1346645116 | Gloria Jean Kennedy | Licensed Practical Nurse | 26032 Newcombe Circle, Leesburg, FL 34748 | 2014-10-23 |
| Find all providers in zip 34748 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932563657 | Elite Care Services, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 707 S Lone Oak Dr, Leesburg, FL 34748-6215 | 2016-04-08 |
| 1033579198 | Tri County Caretakers LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10313 Pleasant View Dr, Leesburg, FL 34788-3853 | 2016-03-02 |
| 1154622686 | Behaviors Plus, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 40438 Emeralda Island Rd, Leesburg, FL 34788-8936 | 2010-11-15 |
| 1013467414 | Tri County Caretakers LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10313 Pleasant View Dr, Leesburg, FL 34788-3853 | 2016-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518568294 | Open Skyes Family Care Home, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5600 Sw 36th St, West Park, FL 33023-6106 | 2020-11-08 |
| 1124628565 | Rachelle Homehealth Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8539 Gate Pkwy W Unit 9134, Jacksonville, FL 32216-1037 | 2020-10-26 |
| 1497368203 | Careola LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3248 Landing Vw, Tavares, FL 32778-2035 | 2020-08-31 |
| 1982218764 | The Home W/ Guiding Hands | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1256 N Florida Ave, Tarpon Springs, FL 34689-2004 | 2020-08-31 |
| 1306459359 | Joy-little Enterprise LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9148 Ridge Blvd, Jacksonville, FL 32208-1265 | 2020-08-28 |
| 1720691082 | Ohana In Home Senior Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 421 W Georgia St, Tallahassee, FL 32301-1011 | 2020-08-26 |
| 1003428467 | Pamella Omelda Odoms-brown | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 541 Shirley Dr., Apopka, FL 32712 | 2020-08-18 |
| 1831700020 | Mikerline Lyns | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10941 Winding Creek Ln, Boca Raton, FL 33428-5664 | 2020-08-12 |
| 1902416993 | Faith Care Center, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3800 Inverrary Blvd Ste 408d, Lauderhill, FL 33319-4359 | 2020-08-04 |
| 1063020188 | Kristine Kaiser Cravener | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1095 Beckman Dr, South Daytona, FL 32119-2499 | 2020-07-14 |
| Find all providers with the same taxonomy | ||||
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| 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.