Provider Demographics
NPI:1801218276
Name:SERENITY COUNSELING AND WELLNESS CENTER
Entity Type:Organization
Organization Name:SERENITY COUNSELING AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MENISSA
Authorized Official - Middle Name:VALAR
Authorized Official - Last Name:HILL-BROX
Authorized Official - Suffix:
Authorized Official - Credentials:LCAC
Authorized Official - Phone:913-707-4822
Mailing Address - Street 1:7933 STATE AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112-2468
Mailing Address - Country:US
Mailing Address - Phone:913-766-5414
Mailing Address - Fax:913-766-5416
Practice Address - Street 1:7933 STATE AVE STE 203
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-2468
Practice Address - Country:US
Practice Address - Phone:913-766-5414
Practice Address - Fax:913-766-5416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-20
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS07560089324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility