MEDICARE: SERENITY HAVEN LIVING

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1841148780
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITY HAVEN LIVING

Provider Business Mailing Address
First Line	:	246 ROBERT C DANIEL JR PKWY # 1318
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30909-0803
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2722 MARGARET CT
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30906-2824
Country	:	US
Telephone Number	:	706-750-0934
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TAMESHA KING
Credential	:
Telephone Number	:	706-750-0934

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	03/17/2026

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