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General NPI Number Information
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NPI Number | 1508311648
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Entity Type | Organization
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Legal Business Name | SERENITY RECOVERY CENTER AT NORTH SHORE MEDICAL CENTER
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Dates
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Enumeration Date | 08/18/2016
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Last Update Date | 08/18/2016
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Provider Practice Location Address
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Address Line | 1100 NW 95TH ST 2ND FL MAIN
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City | MIAMI
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State | FL
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Zip | 33150-2038
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Country | US
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Telephone | 783-671-3267
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 640890
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City | MIAMI
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State | FL
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Zip | 33164-0890
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | ALAFIA JOHNSON
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Credential |
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Telephone | 954-272-6778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State | FL
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