Organization
SERENE HEALTH IPA MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OSCAR MEDINA (CEO)
(619) 259-6999
Entity
Organization
Contact information
Practice address
16335 HARLEM AVE STE 300, TINLEY PARK, IL 60477-2574
(773) 598-8723
(815) 846-5169
Mailing address
9265 SKY PARK CT STE 100, SAN DIEGO, CA 92123-4375
(619) 330-3640
(619) 403-9496
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
—
—
251X00000X
Supports Brokerage Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
03/25/2022
Last updated
10/16/2024
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