NPIMap

Organization Active NPI

Serenity Lane

  • Substance Abuse Rehabilitation Facility
  • Coburg, OR
National Provider Identifier
1467283069
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
SERENITY LANE
Practice address
1 Serenity LN
Coburg, OR 97408-9350
Phone
(541) 687-1110
Fax
(541) 485-8484
NPI assigned
Aug 13, 2024
Last updated
Aug 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Authorized official

Name
Brian Carlin
Title
Chief Financial Officer
Phone
(541) 284-8617

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

1 Serenity LN
Coburg, OR 97408-9350

Mailing address

1 Serenity LN
Coburg, OR 97408-9350
Phone (541) 687-1110

National Provider Directory

National Provider Directory
Tax ID family
Serenity Lane2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1 Serenity Ln
Eugene, OR 97408
Phone (541) 284-5704

Practitioners & affiliated clinicians

Practitioners 110

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 110

NPI Registry JSON

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

{
    "created_epoch": "1723507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1467283069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SERENITY LN",
            "city": "COBURG",
            "state": "OR",
            "postal_code": "974089350",
            "telephone_number": "541-687-1110",
            "fax_number": "541-485-8484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SERENITY LN",
            "city": "COBURG",
            "state": "OR",
            "postal_code": "974089350",
            "telephone_number": "541-687-1110",
            "fax_number": "541-485-8484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY LANE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-13",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "CARLIN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "541-284-8617"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.