Provider Demographics
NPI:1730876228
Name:SERENITY CARE LLC
Entity type:Organization
Organization Name:SERENITY CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SYETTA
Authorized Official - Middle Name:TAMECHA
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:203-565-3495
Mailing Address - Street 1:6225 PHYLISS LN
Mailing Address - Street 2:
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227-9338
Mailing Address - Country:US
Mailing Address - Phone:203-565-3495
Mailing Address - Fax:
Practice Address - Street 1:6225 PHYLISS LN
Practice Address - Street 2:
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227-9338
Practice Address - Country:US
Practice Address - Phone:203-565-3495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-24
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health