Organization
GRANTING SERENTIY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMONN MEDLOCK (CEO)
(804) 528-9889
Entity
Organization
Contact information
Practice address
4410 CLAIBORNE SQ E, HAMPTON, VA 23666-2071
(804) 528-9889
Mailing address
4410 CLAIBORNE SQ E, HAMPTON, VA 23666-2071
(804) 528-9889
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/16/2025
Last updated
07/16/2025
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