Provider Demographics
NPI:1396350484
Name:SERENE CARE HOLDINGS LLC
Entity type:Organization
Organization Name:SERENE CARE HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STECY
Authorized Official - Middle Name:A
Authorized Official - Last Name:OLA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:708-497-0734
Mailing Address - Street 1:10806 REISTERSTOWN RD STE 1F
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4602
Mailing Address - Country:US
Mailing Address - Phone:410-204-2866
Mailing Address - Fax:
Practice Address - Street 1:10806 REISTERSTOWN RD STE 1F
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4602
Practice Address - Country:US
Practice Address - Phone:410-204-2866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-15
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty