Organization
SERYNE COLLECTIVE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHIKOTA BRIDGEMON (EXECUTIVE DIRECTOR)
(312) 998-5527
Entity
Organization
Contact information
Practice address
5007 W AUGUSTA BLVD, CHICAGO, IL 60651-4471
(312) 998-5527
Mailing address
10720 5TH AVE NE, SEATTLE, WA 98125-7260
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
07/19/2025
Last updated
07/19/2025
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