Provider Demographics
NPI:1184294894
Name:SERENITY AND WELLNESS CLINIC
Entity type:Organization
Organization Name:SERENITY AND WELLNESS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIET
Authorized Official - Middle Name:ADEBISI
Authorized Official - Last Name:ADETUNJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-383-9000
Mailing Address - Street 1:PO BOX 1992
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21203-1992
Mailing Address - Country:US
Mailing Address - Phone:443-640-8231
Mailing Address - Fax:410-383-9001
Practice Address - Street 1:2011 CLIFTWOOD AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-1533
Practice Address - Country:US
Practice Address - Phone:443-640-8231
Practice Address - Fax:410-383-9001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-26
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility