Provider Demographics
NPI:1669866406
Name:SERENITY SUCCESS CENTER, INC
Entity Type:Organization
Organization Name:SERENITY SUCCESS CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:954-980-8241
Mailing Address - Street 1:4000 N STATE ROAD 7
Mailing Address - Street 2:SUITE 409-4
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33319-4804
Mailing Address - Country:US
Mailing Address - Phone:954-980-8241
Mailing Address - Fax:
Practice Address - Street 1:4000 N STATE ROAD 7
Practice Address - Street 2:SUITE 409-4
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33319-4804
Practice Address - Country:US
Practice Address - Phone:954-980-8241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-18
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management