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| Type | Company | [sources] | |||
|---|---|---|---|---|---|
| Name | Serenity Blue LLC | [sources] | |||
| Incorporation date | not available | [sources] | |||
| Jurisdiction | not available | [sources] | |||
| Country | United States of America | [sources] | |||
| NPI | 1174131783 | [sources] | |||
| Registration number | not available | [sources] | |||
| Tax Number | 851398761 | [sources] | |||
| Address | Dauphin, PA | [sources] | |||
| Last change | Last processed | First seen | |||
List of providers excluded from participating in the Delaware Medicaid program.
United States of America · DHSS
Medical providers who are precluded from participation in the Medical Assistance Program
United States of America · DHS
us-medpa-e5a5b8661dd20cbd9d4dafa2b5c49ff659629084 · us-medde-7374875a30df09d49b831bcec8b743f8b0d253d5For experts: raw data explorer
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| Sanctions | |||||
|---|---|---|---|---|---|
| Country | Authority | Program | Start date | End date | |
| United States of America | Department of Human Services | - | |||
| Address | ||
|---|---|---|
| Full address | Country | |
| Dauphin, PA | United States of America | |
| United States of America | Pennsylvania Department of Human Services | - | - |