Healthcare Provider Details

I. General information

NPI: 1285896134
Provider Name (Legal Business Name): SERENITY ADULT DAYCENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2008
Last Update Date: 03/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7315 LEE HWY STE B
CHATTANOOGA TN
37421-1560
US

IV. Provider business mailing address

7315 LEE HWY STE B
CHATTANOOGA TN
37421-1560
US

V. Phone/Fax

Practice location:
  • Phone: 423-892-2220
  • Fax: 423-892-5455
Mailing address:
  • Phone: 423-892-2220
  • Fax: 423-892-5455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License NumberC-24A
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberI000000004754
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberC-24A
License Number StateTN
# 4
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number118724
License Number StateTN
# 5
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberC-24A
License Number StateTN

VIII. Authorized Official

Name: MS. DENESSA DENISE CARTWRIGHT
Title or Position: CEO/OWNER
Credential:
Phone: 423-892-2220