Organization
SERENE HEALTH IPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OSCAR V MEDINA (CEO)
(619) 259-6999
Entity
Organization
Contact information
Practice address
410 UNIVERSITY PKWY STE 2000, AIKEN, SC 29801-6808
(706) 524-7134
Mailing address
410 UNIVERSITY PKWY STE 2000, AIKEN, SC 29801-6808
(706) 524-7134
Taxonomy
Speciality
Code
Description
License number
State
103TH0004X
Health Psychologist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/23/2024
Last updated
10/23/2024
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