Healthcare Provider Details

I. General information

NPI: 1689564882
Provider Name (Legal Business Name): SERENITY HOUSE COUNSELING SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

891 S ROHLWING RD
ADDISON IL
60101-4220
US

IV. Provider business mailing address

891 S ROHLWING RD
ADDISON IL
60101-4220
US

V. Phone/Fax

Practice location:
  • Phone: 630-620-6616
  • Fax: 630-620-6616
Mailing address:
  • Phone: 630-620-6616
  • Fax: 630-620-6616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
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: MARK BUSCHBACHER
Title or Position: PRESIDENT / CEO
Credential:
Phone: 630-620-6616