Basic Information
| Provider Information | |||||||||
| NPI: | 1306072210 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SERENITY HEALTHCARE LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 266 | ||||||||
| Address2: | |||||||||
| City: | AUGUSTA | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 078220266 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9733004110 | ||||||||
| FaxNumber: | 9735799007 | ||||||||
| Practice Location | |||||||||
| Address1: | 93 MAIN STREET | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | NEWTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07860 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9733004110 | ||||||||
| FaxNumber: | 9735799007 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2009 | ||||||||
| LastUpdateDate: | 09/02/2009 | ||||||||
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| AuthorizedOfficialLastName: | SWARTS | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
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| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 9733004110 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.