Provider Demographics
NPI:1710752019
Name:SERENITY NOW SUBSTANCE ABUSE CLINIC, LLC
Entity Type:Organization
Organization Name:SERENITY NOW SUBSTANCE ABUSE CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SCHAECHER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:301-758-8551
Mailing Address - Street 1:5007 DECATUR ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LEONARD
Mailing Address - State:MD
Mailing Address - Zip Code:20685-2600
Mailing Address - Country:US
Mailing Address - Phone:301-758-8551
Mailing Address - Fax:
Practice Address - Street 1:5007 DECATUR ST
Practice Address - Street 2:
Practice Address - City:SAINT LEONARD
Practice Address - State:MD
Practice Address - Zip Code:20685-2600
Practice Address - Country:US
Practice Address - Phone:301-758-8551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty