Healthcare Provider Details

I. General information

NPI: 1679953319
Provider Name (Legal Business Name): SERENITY LIVING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2015
Last Update Date: 01/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 WILLIAM ST 1ST FLOOR
ORANGE NJ
07050-4010
US

IV. Provider business mailing address

29 WILLIAM ST 1ST FLOOR
ORANGE NJ
07050-4010
US

V. Phone/Fax

Practice location:
  • Phone: 973-412-6337
  • Fax:
Mailing address:
  • Phone: 973-412-6337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. TWIANA SEARLES
Title or Position: DIRECTOR
Credential:
Phone: 973-412-6337