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General NPI Number Information
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NPI Number | 1811442312
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Entity Type | Organization
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Legal Business Name | SERENITY GROVE, L.L.C.
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Dates
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Enumeration Date | 08/25/2016
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 315 NEWTON BRIDGE RD
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City | ATHENS
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State | GA
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Zip | 30607-1143
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Country | US
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Telephone | 706-389-5157
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Fax | 706-521-3119
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Provider Business Mailing Address
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Address Line | PO BOX 81485
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City | ATHENS
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State | GA
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Zip | 30608-1485
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Country | US
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Telephone | 706-353-1301
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Fax | 706-353-1510
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Authorized Official
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Title or Position | CCO
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Name | MS. SUMER G. VEAL
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Credential |
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Telephone | 706-353-1301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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