Provider Demographics
NPI:1467738096
Name:SERENITY 4 LIFE
Entity Type:Organization
Organization Name:SERENITY 4 LIFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:919-288-6887
Mailing Address - Street 1:3200 CENTRAL HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-7735
Mailing Address - Country:US
Mailing Address - Phone:919-288-6887
Mailing Address - Fax:919-731-9813
Practice Address - Street 1:2111 N WILLIAM ST
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-1437
Practice Address - Country:US
Practice Address - Phone:919-731-9812
Practice Address - Fax:919-731-9813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health