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General NPI Number Information
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NPI Number | 1164731576
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Entity Type | Organization
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Legal Business Name | A PLACE OF SERENITY, INC.
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Dates
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Enumeration Date | 10/03/2010
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Last Update Date | 03/30/2018
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Provider Practice Location Address
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Address Line | 3755 CHERIE GLEN RD
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City | SNELLVILLE
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State | GA
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Zip | 30039-4311
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Country | US
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Telephone | 770-978-9501
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Fax | 770-982-4665
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Provider Business Mailing Address
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Address Line | 3755 CHERIE GLEN RD
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City | SNELLVILLE
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State | GA
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Zip | 30039-4311
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Country | US
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Telephone | 470-545-3682
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Fax | 770-972-3989
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Authorized Official
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Title or Position | DDP/ADMIN.
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Name | MRS. BARBARA ANN CLARK-BECKFORD
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Credential |
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Telephone | 770-865-1003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 067-01-434-1
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License Number State | GA
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