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General NPI Number Information
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NPI Number | 1164707162
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Entity Type | Organization
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Legal Business Name | SERENITY PSYCHIATRIC AND WELLNESS, INC.
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Dates
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Enumeration Date | 10/21/2011
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Last Update Date | 10/21/2011
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Provider Practice Location Address
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Address Line | 184 W MAIN ST SUITE E
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City | NORTON
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State | MA
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Zip | 02766-1243
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Country | US
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Telephone | 508-622-0249
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Fax |
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Provider Business Mailing Address
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Address Line | 184 W MAIN ST SUITE E
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City | NORTON
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State | MA
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Zip | 02766-1243
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Country | US
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Telephone | 508-622-0249
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MR. MATTHEW J WILEY
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Credential | RN
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Telephone | 508-622-0249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | RN233768
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License Number State | MA
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