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Organization
A SERENE LIFE LLC
Active
Organization
A SERENE LIFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ASHLEY WILLIS (OWNER)
(856) 392-1123
Entity
Organization
Contact information
Practice address
100 LIONHEART LN, WEST DEPTFORD, NJ 08086-2253
(856) 392-1123
Mailing address
100 LIONHEART LN, WEST DEPTFORD, NJ 08086-2253
(856) 392-1123
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
NULL
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0450615722
—
NJ
Enumeration date
09/12/2021
Last updated
10/31/2022
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