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General NPI Number Information
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NPI Number | 1558029900
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Entity Type | Organization
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Legal Business Name | SERENITY REHABILITATION CENTER, INC
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Dates
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Enumeration Date | 12/02/2021
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 673 MARTIN LUTHER KING JR BLVD N
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City | PONTIAC
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State | MI
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Zip | 48342-1679
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Country | US
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Telephone | 248-838-3686
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Fax | 248-621-9626
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Provider Business Mailing Address
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Address Line | 35 S JOHNSON ST STE 1D
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City | PONTIAC
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State | MI
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Zip | 48341-1660
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Country | US
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Telephone | 248-444-2772
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHARJEEL KHAN
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Credential |
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Telephone | 248-444-2772
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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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Taxonomy #2
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Taxonomy Code | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number |
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License Number State |
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