Provider Demographics
NPI:1508081159
Name:SERENITY SERVICES LLC
Entity Type:Organization
Organization Name:SERENITY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:LORENZA
Authorized Official - Last Name:LOWERY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:252-767-1912
Mailing Address - Street 1:803 S GARNETT ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-4512
Mailing Address - Country:US
Mailing Address - Phone:252-572-2364
Mailing Address - Fax:
Practice Address - Street 1:803 S GARNETT ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-4512
Practice Address - Country:US
Practice Address - Phone:252-572-2364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty