Provider Demographics
NPI:1083440283
Name:SERENITY MENTAL HEALTH CENTER, LLC
Entity type:Organization
Organization Name:SERENITY MENTAL HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:856-347-2066
Mailing Address - Street 1:15 S POPLAR ST UNIT 218
Mailing Address - Street 2:
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-3607
Mailing Address - Country:US
Mailing Address - Phone:856-347-2066
Mailing Address - Fax:
Practice Address - Street 1:15 S POPLAR ST UNIT 218
Practice Address - Street 2:
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-3607
Practice Address - Country:US
Practice Address - Phone:856-347-2066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-12
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)