Healthcare Provider Details

I. General information

NPI: 1598010043
Provider Name (Legal Business Name): SERENITY HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2012
Last Update Date: 04/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 W BEL AIR AVE STE B
ABERDEEN MD
21001-2236
US

IV. Provider business mailing address

2873 TROYER RD
WHITE HALL MD
21161-9321
US

V. Phone/Fax

Practice location:
  • Phone: 410-273-1030
  • Fax: 410-273-1040
Mailing address:
  • Phone: 443-504-3018
  • Fax: 410-692-0143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number904499
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number904609
License Number StateMD

VIII. Authorized Official

Name: NANCY J TURNER
Title or Position: CEO
Credential: RN
Phone: 443-504-3018