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General NPI Number Information
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NPI Number | 1629361456
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Entity Type | Organization
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Legal Business Name | SERENITY BEHAVIORAL HEALTH INC
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Dates
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Enumeration Date | 05/26/2011
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Last Update Date | 09/20/2011
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Provider Practice Location Address
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Address Line | 3624 HASTINGS DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28311-7605
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Country | US
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Telephone | 910-488-9959
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Fax |
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Provider Business Mailing Address
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Address Line | 3624 HASTINGS DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28311-7605
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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 | PRESIDENT
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Name | MR. ANTHONY PITTMAN
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Credential | LCAS
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Telephone | 910-488-9959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1665
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License Number State | NC
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Taxonomy #2
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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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