Healthcare Provider Details

I. General information

NPI: 1992641591
Provider Name (Legal Business Name): THE SERENE PLACE BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1316 MINNESOTA WAY
UPPER MARLBORO MD
20774-6060
US

IV. Provider business mailing address

1316 MINNESOTA WAY
UPPER MARLBORO MD
20774-6060
US

V. Phone/Fax

Practice location:
  • Phone: 202-702-6789
  • Fax:
Mailing address:
  • Phone: 202-702-6789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: DR. ATOLA NNENNA IDIKA
Title or Position: DIRECTOR
Credential: IDIKA
Phone: 202-702-6789