Provider Demographics
NPI:1881857316
Name:SERENITY INC
Entity Type:Organization
Organization Name:SERENITY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROOSEVELT
Authorized Official - Middle Name:
Authorized Official - Last Name:COHENS
Authorized Official - Suffix:
Authorized Official - Credentials:EDD LGSW LPC CACII
Authorized Official - Phone:202-373-2853
Mailing Address - Street 1:1718 5TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-1818
Mailing Address - Country:US
Mailing Address - Phone:202-506-2877
Mailing Address - Fax:202-506-4291
Practice Address - Street 1:1718 5TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-1818
Practice Address - Country:US
Practice Address - Phone:202-506-2877
Practice Address - Fax:202-506-4291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC985251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management