Serene Life Community Services LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

SERENE LIFE COMMUNITY SERVICES LLC

Practice address

13209 Fairwood Rd
South Prince George, VA 23805-7817

Phone

(804) 931-2005

NPI assigned

May 26, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lisa FriendNPI 1215711692

Title

Owner

Phone

(804) 931-2005

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Sa'Rena Friend

  • Community/Behavioral Health Agency
  • Petersburg, VA
  • NPI 1215711692
  NPD Authorized official
• Iteisha James-Crenshaw, LCSW

  • Community/Behavioral Health Agency
  • Petersburg, VA
  • NPI 1245016807
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1685059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695600000000",
    "number": "1487347407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13209 FAIRWOOD RD",
            "city": "SOUTH PRINCE GEORGE",
            "state": "VA",
            "postal_code": "238057817",
            "telephone_number": "804-931-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13209 FAIRWOOD RD",
            "city": "SOUTH PRINCE GEORGE",
            "state": "VA",
            "postal_code": "238057817",
            "telephone_number": "804-931-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENE LIFE COMMUNITY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-26",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A",
        "authorized_official_last_name": "FRIEND",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-931-2005"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candace Raburn
• Charlisa Rhodes, LPN
• Dana Michelle Robinson
• Erika Saunders
• Tracey Seege
• Gabrielle Sinclair
• Angela Elizabeth Taleb
• The Luck Group Outdoors
• Brittany Jane Townsend
• Shakema Tucker

• Adult Mental Health Clinic/Center in South Prince George, VA
• Providers in South Prince George, VA by specialty
• Adult Mental Health Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.