Provider Demographics
NPI:1619786407
Name:SERENITY NOW BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:SERENITY NOW BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:QUEENIE
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:ATILANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-287-7045
Mailing Address - Street 1:417 MACE BLVD STE J-102
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95618-6053
Mailing Address - Country:US
Mailing Address - Phone:916-287-7045
Mailing Address - Fax:
Practice Address - Street 1:2927, 2929, 2931 SALEM AVENUE
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-2633
Practice Address - Country:US
Practice Address - Phone:916-287-7045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness