Provider Demographics
NPI:1558988899
Name:SERENE CENTER LLC
Entity Type:Organization
Organization Name:SERENE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SAFIA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:FARAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-983-0487
Mailing Address - Street 1:4940 W 77TH ST STE 76
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4805
Mailing Address - Country:US
Mailing Address - Phone:651-983-0487
Mailing Address - Fax:
Practice Address - Street 1:4940 W 77TH ST STE 76
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4805
Practice Address - Country:US
Practice Address - Phone:651-983-0487
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management