# A SERENE LIFE LLC

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

## Provider details

- **NPI number:** 1982373932
- **Authorized official:** MS. ASHLEY WILLIS (OWNER)
- **Authorized official phone:** (856) 392-1123

## Contact information

- **Practice address:** 100 LIONHEART LN, WEST DEPTFORD, NJ 08086-2253
- **Practice address phone:** (856) 392-1123
- **Mailing address:** 100 LIONHEART LN, WEST DEPTFORD, NJ 08086-2253
- **Mailing address phone:** (856) 392-1123

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |
| 385HR2060X | Child Intellectual and/or Developmental Disabilities Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 09/12/2021
- **Last updated:** 10/31/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0450615722 | — | NJ |