Provider Demographics
NPI:1417043373
Name:SERENITY PARTNERS, LLC DBA SERENITY BY THE SEA
Entity Type:Organization
Organization Name:SERENITY PARTNERS, LLC DBA SERENITY BY THE SEA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT; EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICAHEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-325-3000
Mailing Address - Street 1:PO BOX 839
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:OR
Mailing Address - Zip Code:97103-0839
Mailing Address - Country:US
Mailing Address - Phone:503-325-3000
Mailing Address - Fax:503-325-8927
Practice Address - Street 1:263 W EXCHANGE ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-6142
Practice Address - Country:US
Practice Address - Phone:503-325-3000
Practice Address - Fax:503-325-8927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility