Provider Demographics
NPI:1215680681
Name:SERENE RESIDENTIALS LLC
Entity type:Organization
Organization Name:SERENE RESIDENTIALS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNITA
Authorized Official - Middle Name:
Authorized Official - Last Name:AJEBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-556-9024
Mailing Address - Street 1:205 DELAWARE DR
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-2570
Mailing Address - Country:US
Mailing Address - Phone:614-556-9024
Mailing Address - Fax:
Practice Address - Street 1:205 DELAWARE DR
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-2570
Practice Address - Country:US
Practice Address - Phone:614-556-9024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory