Provider Demographics
NPI:1326721044
Name:SEREN INCORPORATED
Entity Type:Organization
Organization Name:SEREN INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:EKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-360-7460
Mailing Address - Street 1:12269 GREENLEAF AVE
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3328
Mailing Address - Country:US
Mailing Address - Phone:516-360-7460
Mailing Address - Fax:
Practice Address - Street 1:12269 GREENLEAF AVE
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-3328
Practice Address - Country:US
Practice Address - Phone:516-360-7460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities