Provider Demographics
NPI:1689196578
Name:SERENITY TREATMENT AND COUNSELING CENTER INC
Entity Type:Organization
Organization Name:SERENITY TREATMENT AND COUNSELING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT/ACCOUNTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:PERTEET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-881-2740
Mailing Address - Street 1:10641 S HALE AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-2700
Mailing Address - Country:US
Mailing Address - Phone:800-881-2740
Mailing Address - Fax:888-557-5031
Practice Address - Street 1:19408 NORTH CREEK DRIVE
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60411-8649
Practice Address - Country:US
Practice Address - Phone:708-251-3952
Practice Address - Fax:708-251-5496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-12
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadoneGroup - Single Specialty