Provider Demographics
NPI: | 1407731201 |
---|---|
Name: | SERENITY UPTOWN CONSULTING & CO |
Entity type: | Organization |
Organization Name: | SERENITY UPTOWN CONSULTING & CO |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | FELICIA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MARLEY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 336-302-4332 |
Mailing Address - Street 1: | 819 VALLEY OAK DR |
Mailing Address - Street 2: | |
Mailing Address - City: | GREENSBORO |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 27406-8225 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 336-302-4332 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 8011 N POINT BLVD |
Practice Address - Street 2: | |
Practice Address - City: | WINSTON SALEM |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27106-3879 |
Practice Address - Country: | US |
Practice Address - Phone: | 410-500-2761 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2025-08-11 |
Last Update Date: | 2025-08-13 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No | 251S00000X | Agencies | Community/Behavioral Health |