Provider Demographics
NPI:1245051002
Name:JALAJA SERENE HEALTH LLC
Entity type:Organization
Organization Name:JALAJA SERENE HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-401-9307
Mailing Address - Street 1:180 STREAMSIDE CIRCLE
Mailing Address - Street 2:APT 5
Mailing Address - City:SMYRNA
Mailing Address - State:DE
Mailing Address - Zip Code:19977
Mailing Address - Country:US
Mailing Address - Phone:302-401-9307
Mailing Address - Fax:
Practice Address - Street 1:180 STREAMSIDE CIRCLE
Practice Address - Street 2:APT 5
Practice Address - City:SMYRNA
Practice Address - State:DE
Practice Address - Zip Code:19977
Practice Address - Country:US
Practice Address - Phone:302-401-9307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)