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General NPI Number Information
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NPI Number | 1295855245
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Entity Type | Organization
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Legal Business Name | THE SERENITY CENTER, INC.
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5960 STEWART PKWY
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-2372
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Country | US
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Telephone | 404-247-0344
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Fax | 678-370-0557
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Provider Business Mailing Address
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Address Line | 5960 STEWART PKWY
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-2372
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Country | US
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Telephone | 404-247-0344
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Fax | 678-370-0557
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Authorized Official
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Title or Position | CEO
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Name | CLINTON S. PAYNE
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Credential | LPC
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Telephone | 404-247-0344
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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 | LPC002603
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License Number State | GA
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