Serenity Recovery Treatment Center

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

SERENITY RECOVERY TREATMENT CENTER

Practice address

672 W 11TH St Ste 305
Tracy, CA 95376-3821

Phone

(209) 831-9767

NPI assigned

Feb 17, 2022

Organization subpart

No

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

Authorized official

Name

Lauraine Mildred Fogarty, CCMI, CADCNPI 1134697980

Title

President

Phone

(209) 831-9767

Specialties & licenses 1

Addresses

Other names 1

• SERENITY RECOVERY TREATMENT CENTER Doing business as

Practitioners 1

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

• Lauraine Mildred Fogarty, RADT-1

  • Addiction (Substance Use Disorder) Counselor
  • Tracy, CA
  • NPI 1134697980
  NPD Authorized official

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

{
    "created_epoch": "1645056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645056000000",
    "number": "1467107516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "672 W 11TH ST STE 305",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763821",
            "telephone_number": "209-831-9767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "672 W 11TH ST STE 305",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763821",
            "telephone_number": "209-831-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY RECOVERY TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-17",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-01",
        "status": "A",
        "authorized_official_last_name": "FOGARTY",
        "authorized_official_first_name": "LAURAINE",
        "authorized_official_middle_name": "MILDRED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-831-9767",
        "authorized_official_credential": "CCMI, CADC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SERENITY RECOVERY TREATMENT CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mitchell L Seitz, M.D.
• Violeta Seitz, FNP
• Arvinder Sekhon
• Jennifer Senior
• Noely Sepulveda-Reyes
• Madhavi Suresh Seri
• Natalie Serrato
• Jamiela Shah
• Krina Shah
• Meenal Amish Shah, M.D.

• Substance Abuse Rehabilitation Facility in Tracy, CA
• Providers in Tracy, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; 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.