Healthcare Provider Details

I. General information

NPI: 1548101264
Provider Name (Legal Business Name): SERENITY HEAVEN NETWORK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 RELLA BLVD
MONTEBELLO NY
10901-4241
US

IV. Provider business mailing address

400 RELLA BLVD
MONTEBELLO NY
10901-4241
US

V. Phone/Fax

Practice location:
  • Phone: 877-937-3736
  • Fax:
Mailing address:
  • Phone: 877-937-3736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. LYNDA VALERY
Title or Position: OWNER
Credential:
Phone: 877-937-3736