Provider Demographics
NPI:1114432739
Name:SERENITY NOW HEALTHCARE OF MS LLC
Entity Type:Organization
Organization Name:SERENITY NOW HEALTHCARE OF MS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-596-2449
Mailing Address - Street 1:5011 VIRGINIA ST
Mailing Address - Street 2:
Mailing Address - City:BAY ST LOUIS
Mailing Address - State:MS
Mailing Address - Zip Code:39520-7010
Mailing Address - Country:US
Mailing Address - Phone:888-371-1924
Mailing Address - Fax:888-371-1924
Practice Address - Street 1:5011 VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:BAY ST LOUIS
Practice Address - State:MS
Practice Address - Zip Code:39520-7010
Practice Address - Country:US
Practice Address - Phone:888-371-1924
Practice Address - Fax:888-371-1924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-05
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251B00000XAgenciesCase Management
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty