Provider Demographics
NPI:1043717937
Name:SERENITY HILLS LIFE CENTER
Entity Type:Organization
Organization Name:SERENITY HILLS LIFE CENTER
Other - Org Name:HEART 2 HEART VOLUNTEERS, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-277-4657
Mailing Address - Street 1:220 BETHANY PIKE
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-1608
Mailing Address - Country:US
Mailing Address - Phone:304-281-0474
Mailing Address - Fax:304-905-9333
Practice Address - Street 1:667 STONE SHANNON RD
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6742
Practice Address - Country:US
Practice Address - Phone:304-277-4657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-09
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder