Healthcare Provider Details

I. General information

NPI: 1548608045
Provider Name (Legal Business Name): SERENITY HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2013
Last Update Date: 06/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2227 HARBIN TERRACE DR
MORROW GA
30260-1461
US

IV. Provider business mailing address

2227 HARBIN TERRACE DR
MORROW GA
30260-1461
US

V. Phone/Fax

Practice location:
  • Phone: 404-216-8990
  • Fax:
Mailing address:
  • Phone: 404-216-8990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. ZAKKENYA SENA JOHNSON
Title or Position: OWNER
Credential:
Phone: 404-216-8990