Provider Demographics
NPI:1598010043
Name:SERENITY HEALTH, LLC
Entity Type:Organization
Organization Name:SERENITY HEALTH, LLC
Other - Org Name:SERENITY HEALTH, ABERDEEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:J
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:443-504-3018
Mailing Address - Street 1:2873 TROYER RD
Mailing Address - Street 2:
Mailing Address - City:WHITE HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21161-9321
Mailing Address - Country:US
Mailing Address - Phone:443-504-3018
Mailing Address - Fax:410-692-0143
Practice Address - Street 1:780 W BEL AIR AVE STE B
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MD
Practice Address - Zip Code:21001-2236
Practice Address - Country:US
Practice Address - Phone:410-273-1030
Practice Address - Fax:410-273-1040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-20
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD904499261QM2800X
MD904609261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD421118900Medicaid