Provider Demographics
NPI:1376084210
Name:SERENITY RECOVERY CENTER OF DAYTON LLC
Entity Type:Organization
Organization Name:SERENITY RECOVERY CENTER OF DAYTON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:MS
Authorized Official - First Name:JANAY
Authorized Official - Middle Name:
Authorized Official - Last Name:CORBITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-912-2674
Mailing Address - Street 1:PO BOX 1651
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40588-1651
Mailing Address - Country:US
Mailing Address - Phone:502-912-2674
Mailing Address - Fax:
Practice Address - Street 1:2339 HARRODSBURG RD APT 6
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3327
Practice Address - Country:US
Practice Address - Phone:502-912-2674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-11
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility