Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health (Including Community Mental Health Center) |
261QM0801X | B4[14] | Community Mental Health Center | |
Attendant Care Provider |
3747A0650X | |||
Case Manager/Care Coordinator |
171M00000X | |||
Clinical |
1041C0700X | 80 | Licensed Clinical Social Worker | |
Day Training, Developmentally Disabled Services |
251C00000X | |||
Home Delivered Meals |
332U00000X | 87 | All Other Suppliers | |
Homemaker |
376J00000X | |||
Mental Health |
101YM0800X | |||
Personal Care Attendant |
3747P1801X | |||
Professional |
101YP2500X | |||
Rehabilitation, Substance Use Disorder |
261QR0405X | |||
Respite Care |
385H00000X | |||
Supports Brokerage |
251X00000X |
| NPI # | 1144066416 |
||||
| LBN Legal business name | SERENE HEALTH IPA MEDICAL CORPORATION | ||||
| Authorized official | OSCAR V MEDINA - (CEO) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 07/05/2024 | ||||
| Last updated | 10/16/2024 - More than a year ago | ||||
| Identifiers |
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SERENE HEALTH IPA MEDICAL CORPORATION
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