Serenity Center of Youngstown

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

01-7562 Issued in OH

Legal business name

SERENITY CENTER OF YOUNGSTOWN

Practice address

11369 Market St
North Lima, OH 44452-9782

Phone

(330) 965-9999

Fax

(330) 757-0000

NPI assigned

Nov 10, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Cyndee Fisher

Title

Credentialing & Contracting Coord

Phone

(330) 965-9999

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Serenity Center of Youngstown LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Serenity Center of Youngstown, LLC

  • Community/Behavioral Health Agency
  • North Lima, OH
  • NPI 1093257529
  NPD tax ID
• Serenity Center of Youngstown, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • North Lima, OH
  • NPI 1760861249
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Muhannad Kassawat, MD

  • Addiction Psychiatry Physician
  • North Lima, OH
  • NPI 1023266533
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1478736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677715200000",
    "number": "1154863975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11369 MARKET ST",
            "city": "NORTH LIMA",
            "state": "OH",
            "postal_code": "444529782",
            "telephone_number": "330-965-9999",
            "fax_number": "330-757-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11369 MARKET ST",
            "city": "NORTH LIMA",
            "state": "OH",
            "postal_code": "444529782",
            "telephone_number": "330-965-9999",
            "fax_number": "330-757-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3657 Mahoning Ave",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445153018",
            "country_code": "US",
            "telephone_number": "330-965-9999",
            "fax_number": "330-757-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1947 E Market St",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "OH",
            "postal_code": "444836644",
            "country_code": "US",
            "telephone_number": "330-965-9999",
            "fax_number": "330-757-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SERENITY CENTER OF YOUNGSTOWN",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-10",
        "last_updated": "2023-03-02",
        "certification_date": "2021-03-02",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "CYNDEE",
        "authorized_official_title_or_position": "CREDENTIALING & CONTRACTING COORD",
        "authorized_official_telephone_number": "330-965-9999",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OH",
            "license": "01-7562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0193654",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brady Dwayne Reece, RN
• Tawnya Dianne Reents, NP
• Rolling Acres Care Center LLC
• Roots to Healing Counseling & Wellness LLC
• Teri Lynn Ruiz, LPN
• Serenity Center of Youngstown, LLC
• Serenity Center of Youngstown, LLC
• Manuel Michael Spirtos, M.D.
• Jodi Michelle Stewart, M.ED
• Michael Francis Tatko, PA-C

• All providers in North Lima, OH
• Community/Behavioral Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.