Healthcare Provider Details

I. General information

NPI: 1538971833
Provider Name (Legal Business Name): SERENITY SISTAS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2025
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

266 HILLSMERE DR
ANNAPOLIS MD
21403-3736
US

IV. Provider business mailing address

266 HILLSMERE DR
ANNAPOLIS MD
21403-3736
US

V. Phone/Fax

Practice location:
  • Phone: 410-507-7583
  • Fax:
Mailing address:
  • Phone: 410-507-7583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ANGEL TRAYNOR
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 410-507-7583