Provider Demographics
NPI:1326748880
Name:SERENE CARE HOLDINGS LLC
Entity Type:Organization
Organization Name:SERENE CARE HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STECY
Authorized Official - Middle Name:
Authorized Official - Last Name:OLA
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP, FNP, PMH
Authorized Official - Phone:410-204-2866
Mailing Address - Street 1:10806 REISTERSTOWN RD STE 1F
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4602
Mailing Address - Country:US
Mailing Address - Phone:410-204-2866
Mailing Address - Fax:
Practice Address - Street 1:10806 REISTERSTOWN RD STE 1F
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4602
Practice Address - Country:US
Practice Address - Phone:410-204-2866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SERENE CARE HOLDINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-03
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty