MEDICARE: SERENOVA HEALTH GROUP 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	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1659217750
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENOVA HEALTH GROUP LLC

Provider Business Mailing Address
First Line	:	16593 CHINA BERRY CT
Second Line	:
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-6390
Country	:	US
Telephone Number	:	840-228-7741
Fax Number	:	840-228-7741

Provider Business Practice Location Address
First Line	:	16593 CHINA BERRY CT
Second Line	:
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-6390
Country	:	US
Telephone Number	:	840-228-7741
Fax Number	:	840-228-7741

Authorized Official
Title or Position	:	CEO
Name	:	JOYCE J MCCOLLUM
Credential	:
Telephone Number	:	840-228-7741

Provider Enumeration Date	:	04/28/2026
Last Update Date	:	05/01/2026

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