# SERENE HEALTH IPA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235950080
- **Authorized official:** OSCAR V MEDINA (CEO)
- **Authorized official phone:** (619) 259-6999

## Contact information

- **Practice address:** 410 UNIVERSITY PKWY STE 2000, AIKEN, SC 29801-6808
- **Practice address phone:** (706) 524-7134
- **Mailing address:** 410 UNIVERSITY PKWY STE 2000, AIKEN, SC 29801-6808
- **Mailing address phone:** (706) 524-7134

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TH0004X | Health Psychologist | — | NULL | — |
| 103TH0004X | Health Psychologist | — | — | — |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | — |
| 171M00000X | Case Manager/Care Coordinator | — | — | — |
| 172V00000X | Community Health Worker | — | NULL | — |
| 172V00000X | Community Health Worker | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 10/23/2024
- **Last updated:** 10/23/2024