Serenity Recovery Clinic, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

3091 Issued in WI

Legal business name

SERENITY RECOVERY CLINIC, LLC

Practice address

6510 W Layton Ave
Suite 5
Greenfield, WI 53220-4573

Phone

(414) 763-7751

Fax

(414) 763-7755

NPI assigned

May 18, 2015

Organization subpart

No

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

Authorized official

Name

Mr. John K Luznicky, CSACNPI 1730129636

Title

Program Director/Counselor

Phone

(414) 763-7751

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• John K Luznicky, CSAC

  • Addiction (Substance Use Disorder) Counselor
  • Greenfield, WI
  • NPI 1730129636
  NPD (past) Authorized official

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

{
    "created_epoch": "1431907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431907200000",
    "number": "1679951057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6510 W LAYTON AVE",
            "address_2": "SUITE 5",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204573",
            "telephone_number": "414-763-7751",
            "fax_number": "414-763-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6510 W LAYTON AVE",
            "address_2": "SUITE 5",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204573",
            "telephone_number": "414-763-7751",
            "fax_number": "414-763-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY RECOVERY CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-18",
        "last_updated": "2015-05-18",
        "status": "A",
        "authorized_official_last_name": "LUZNICKY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR/COUNSELOR",
        "authorized_official_telephone_number": "414-763-7751",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CSAC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "3091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609814367",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott J. Wagenknecht, LLC
• Brandy L Scott, APNP
• Theresa Sebestyen, PT
• Anna E Seckar-Anderson, APNP
• Kris Sell, PT
• Mayra Serna Garcia, MS, OTR/L
• Linda M Serrano, M.D.
• Judith Joyce Sewell, LPN
• Janet A Shafer, RN,MS,LPC
• Amer Shah

• Community/Behavioral Health Agency in Greenfield, WI
• Providers in Greenfield, WI by specialty
• Community/Behavioral Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2015; 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.