NPIMap

Organization Active NPI

Serenity Health, LLC

Doing business as Serenity Health - Elkton

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Elkton, MD
National Provider Identifier
1639424187
Registry record updated Apr 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
904609 Issued in MD
Legal business name
SERENITY HEALTH, LLC
Doing business as
Serenity Health - Elkton
Practice address
953 W Pulaski Hwy
Elkton, MD 21921-4714
Phone
(443) 485-6544
Fax
(443) 485-6442
NPI assigned
Jul 20, 2012
Last updated
Apr 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2018

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

Authorized official

Name
Nancy J Turner, MBR, RN, DMP
Title
Ceo
Phone
(443) 504-3018

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 904609 MD Primary

Addresses

Primary practice location

953 W Pulaski Hwy
Elkton, MD 21921-4714

Mailing address

2873 Troyer Rd
White Hall, MD 21161-9321
Phone (443) 504-3018

Other identifiers 1

IdentifierTypeStateIssuer
421677600MedicaidMD

Other names 1

  • Serenity Health - Elkton Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Serenity Health - Aberdeen4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524096000000",
    "number": "1639424187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2873 TROYER RD",
            "city": "WHITE HALL",
            "state": "MD",
            "postal_code": "211619321",
            "telephone_number": "443-504-3018",
            "fax_number": "410-692-0143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "953 W PULASKI HWY",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219214714",
            "telephone_number": "443-485-6544",
            "fax_number": "443-485-6442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-20",
        "last_updated": "2018-04-19",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-504-3018",
        "authorized_official_credential": "MBR, RN, DMP"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MD",
            "license": "904609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "421677600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serenity Health - Elkton",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Serenity Health - Elkton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elkton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2018; 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.