Provider Demographics
NPI:1851089536
Name:SERENE OASIS CORP
Entity Type:Organization
Organization Name:SERENE OASIS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THAWRA
Authorized Official - Middle Name:JULIA
Authorized Official - Last Name:COTTONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-413-1213
Mailing Address - Street 1:PO BOX 43
Mailing Address - Street 2:
Mailing Address - City:HAZEL PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48030-0043
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1429 E GEORGE AVE
Practice Address - Street 2:
Practice Address - City:HAZEL PARK
Practice Address - State:MI
Practice Address - Zip Code:48030-2615
Practice Address - Country:US
Practice Address - Phone:586-413-1213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty