Provider Demographics
NPI:1588902084
Name:SERENITY BEHAVIIROAL CENTER, LLC
Entity type:Organization
Organization Name:SERENITY BEHAVIIROAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IFEANYI
Authorized Official - Middle Name:
Authorized Official - Last Name:OKAFOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-240-8853
Mailing Address - Street 1:105 DAVE WARLICK DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-4411
Mailing Address - Country:US
Mailing Address - Phone:704-240-8853
Mailing Address - Fax:704-748-2345
Practice Address - Street 1:105 DAVE WARLICK DR
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-4411
Practice Address - Country:US
Practice Address - Phone:704-240-8853
Practice Address - Fax:704-748-2345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7873251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health