Healthcare Provider Details

I. General information

NPI: 1194106740
Provider Name (Legal Business Name): SERENITY POINT RECOVERY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2015
Last Update Date: 06/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15140 16TH AVE
MARNE MI
49435-9605
US

IV. Provider business mailing address

121 CAPITAL AVE NE
BATTLE CREEK MI
49017-3928
US

V. Phone/Fax

Practice location:
  • Phone: 616-209-0600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License NumberSA0700123
License Number StateMI

VIII. Authorized Official

Name: MS. AMBER HOWE
Title or Position: COO
Credential:
Phone: 616-209-0600