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General NPI Number Information
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NPI Number | 1609146695
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Entity Type | Organization
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Legal Business Name | SOUL OF SERENITY CENTER
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Dates
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Enumeration Date | 01/06/2012
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Last Update Date | 01/06/2012
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Provider Practice Location Address
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Address Line | 7119 AFTON DR STE 202
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City | KNOXVILLE
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State | TN
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Zip | 37918-5701
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Country | US
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Telephone | 865-313-3707
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Fax | 865-377-3952
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Provider Business Mailing Address
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Address Line | 7119 AFTON DR STE 202
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City | KNOXVILLE
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State | TN
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Zip | 37918-5701
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Country | US
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Telephone | 865-313-3707
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Fax | 865-377-3952
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Authorized Official
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Title or Position | PARTNER
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Name | MS. LINDA M CATLIN
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Credential | LMSW
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Telephone | 865-313-3707
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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 | 5350
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License Number State | TN
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