MEDICARE: CEDARWOOD SERENITY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1073454716
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CEDARWOOD SERENITY LLC

Provider Business Mailing Address
First Line	:	108 WINDOVER WAY
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31088-6721
Country	:	US
Telephone Number	:	646-418-8394
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 WINDOVER WAY
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31088-6721
Country	:	US
Telephone Number	:	646-418-8394
Fax Number	:

Authorized Official
Title or Position	:	PMHNP
Name	:	CHANIECE RUMPH
Credential	:
Telephone Number	:	646-418-8394

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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