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General NPI Number Information
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NPI Number | 1396264313
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Entity Type | Organization
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Legal Business Name | SERENITY WELLNESS LLC
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Dates
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Enumeration Date | 09/11/2017
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 300 PLAZA MIDDLESEX
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City | MIDDLETOWN
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State | CT
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Zip | 06457-3455
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Country | US
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Telephone | 860-975-7455
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Fax |
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Provider Business Mailing Address
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Address Line | 388 E MAIN ST
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City | BRANFORD
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State | CT
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Zip | 06405-2914
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MEREDITH BAILEY
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Credential | APRN
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Telephone | 860-975-7455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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