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General NPI Number Information
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NPI Number | 1588025365
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Entity Type | Organization
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Legal Business Name | SERENITY LIFE CENTER
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Dates
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Enumeration Date | 03/08/2016
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Last Update Date | 03/08/2016
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Provider Practice Location Address
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Address Line | 6186 HEFLEY ST
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City | WESTMINSTER
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State | CA
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Zip | 92683-2967
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Country | US
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Telephone | 714-892-0697
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Fax |
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Provider Business Mailing Address
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Address Line | 6186 HEFLEY ST
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City | WESTMINSTER
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State | CA
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Zip | 92683-2967
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Country | US
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Telephone | 714-892-0697
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JULIA ANN BELLINI
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Credential | CATC
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Telephone | 714-715-7884
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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 | B1307081124
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License Number State | CA
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