Provider Demographics
NPI:1104183797
Name:PLAINVIEW SERENITY CENTER,INC.
Entity type:Organization
Organization Name:PLAINVIEW SERENITY CENTER,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:LCDC,LPC,LBSW
Authorized Official - Phone:806-293-9722
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:450 N IH 27
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79073-0278
Mailing Address - Country:US
Mailing Address - Phone:806-293-9722
Mailing Address - Fax:806-293-1822
Practice Address - Street 1:450 INTERSTATE 27
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072-0055
Practice Address - Country:US
Practice Address - Phone:806-293-9722
Practice Address - Fax:806-293-1822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX486-486A324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility