Healthcare Provider Details

I. General information

NPI: 1619778727
Provider Name (Legal Business Name): SERENITY SPRINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3664 W NC 97
SPRING HOPE NC
27882-8077
US

IV. Provider business mailing address

135 SILENT BROOK TRL
FRANKLINTON NC
27525-6622
US

V. Phone/Fax

Practice location:
  • Phone: 347-845-1110
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health 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. LAKENYA DANIELS
Title or Position: OWNER
Credential:
Phone: 347-845-1110