Provider Demographics
NPI:1477810893
Name:SERENITY PLACE
Entity Type:Organization
Organization Name:SERENITY PLACE
Other - Org Name:NCADD
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-925-6980
Mailing Address - Street 1:101 MANCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-2205
Mailing Address - Country:US
Mailing Address - Phone:603-625-6980
Mailing Address - Fax:603-625-6982
Practice Address - Street 1:101 MANCHESTER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-2205
Practice Address - Country:US
Practice Address - Phone:603-625-6980
Practice Address - Fax:603-625-6982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management