Provider Demographics
NPI:1134542251
Name:SERENITY ROW.INC.
Entity type:Organization
Organization Name:SERENITY ROW.INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:JILL
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-502-0305
Mailing Address - Street 1:3673 ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-3625
Mailing Address - Country:US
Mailing Address - Phone:561-502-0305
Mailing Address - Fax:561-649-5536
Practice Address - Street 1:3613 COCONUT RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-3585
Practice Address - Country:US
Practice Address - Phone:561-502-0305
Practice Address - Fax:561-649-5536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility