Provider Demographics
NPI:1336927987
Name:SERENE RECOVERY
Entity Type:Organization
Organization Name:SERENE RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KHALED
Authorized Official - Middle Name:
Authorized Official - Last Name:AL-ALAWNEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-964-3632
Mailing Address - Street 1:2628 VINEYARD AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90016-2928
Mailing Address - Country:US
Mailing Address - Phone:918-964-3632
Mailing Address - Fax:
Practice Address - Street 1:2628 VINEYARD AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90016-2928
Practice Address - Country:US
Practice Address - Phone:918-964-3632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder