Provider Demographics
NPI:1194404921
Name:SERENE CARE MANAGEMENT
Entity type:Organization
Organization Name:SERENE CARE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD OF DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-364-3050
Mailing Address - Street 1:310 23RD ST STE 2
Mailing Address - Street 2:
Mailing Address - City:WATERVLIET
Mailing Address - State:NY
Mailing Address - Zip Code:12189-2126
Mailing Address - Country:US
Mailing Address - Phone:518-364-3050
Mailing Address - Fax:838-500-7993
Practice Address - Street 1:310 23RD ST STE 2
Practice Address - Street 2:
Practice Address - City:WATERVLIET
Practice Address - State:NY
Practice Address - Zip Code:12189-2126
Practice Address - Country:US
Practice Address - Phone:518-364-3050
Practice Address - Fax:838-500-7993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management