Provider Demographics
NPI:1265154009
Name:SERENE MINDS CENTER
Entity type:Organization
Organization Name:SERENE MINDS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:MR
Authorized Official - First Name:GILDEON
Authorized Official - Middle Name:
Authorized Official - Last Name:THUO
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTIONER
Authorized Official - Phone:732-484-3208
Mailing Address - Street 1:180 TALMADGE RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-2860
Mailing Address - Country:US
Mailing Address - Phone:732-484-3208
Mailing Address - Fax:
Practice Address - Street 1:180 TALMADGE RD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-2860
Practice Address - Country:US
Practice Address - Phone:732-484-3208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty