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General NPI Number Information
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NPI Number | 1417547290
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Entity Type | Organization
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Legal Business Name | SERENITEE AT ITS BEST
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Dates
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Enumeration Date | 01/25/2021
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Last Update Date | 01/25/2021
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Provider Practice Location Address
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Address Line | 545 DAVISTOWN RD
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City | MIDWAY
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State | KY
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Zip | 40347-9504
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Country | US
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Telephone | 859-753-7752
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4428
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City | MIDWAY
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State | KY
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Zip | 40347-4428
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Country | US
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Telephone | 859-753-7752
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | STEPHANIE RAGLIN
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Credential | LCADC
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Telephone | 859-753-7752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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