Provider Demographics
NPI:1477274702
Name:SERENITY HEALTHCARE ASSOCIATES LLC
Entity Type:Organization
Organization Name:SERENITY HEALTHCARE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JELIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:AKOMBE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:732-527-5519
Mailing Address - Street 1:6 BRIARWOOD CT
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-1803
Mailing Address - Country:US
Mailing Address - Phone:732-527-5519
Mailing Address - Fax:
Practice Address - Street 1:6 BRIARWOOD CT
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-1803
Practice Address - Country:US
Practice Address - Phone:732-527-5519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty