Healthcare Provider Details

I. General information

NPI: 1891614483
Provider Name (Legal Business Name): SERN CLINICAL RECOVERY CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4924 ERNESTO COPPEL CAMPANA CERRITOS RESORT
MAZATLAN SINALOA
82112
MX

IV. Provider business mailing address

4924 ERNESTO COPPEL CAMPANA OCEANICA CERRITOS RESSORT
MAZATLAN MAZATLAN
82112
MX

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MS. ROCIO ELIZABETH DIAZ SANTANA
Title or Position: MEDICAL RESPONSIBLE
Credential: MD
Phone: 619-947-2277