Provider Demographics
NPI:1689564676
Name:SERENITY OASIS LLC
Entity type:Organization
Organization Name:SERENITY OASIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STACIANN
Authorized Official - Middle Name:SHASHONNA
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:757-991-2789
Mailing Address - Street 1:210 POINTER CIR APT 3
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-6915
Mailing Address - Country:US
Mailing Address - Phone:757-991-2789
Mailing Address - Fax:
Practice Address - Street 1:4306 HOLLAND PLAZA SHOPPING CTR # 2
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1194
Practice Address - Country:US
Practice Address - Phone:757-992-0780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty