Serenity Recovery Village

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

APPLIED FOR Issued in FL

Legal business name

SERENITY RECOVERY VILLAGE

Practice address

681 SW Whitmore Dr
Port Saint Lucie, FL 34984-3567

Phone

(772) 214-1195

Fax

(772) 382-0637

NPI assigned

Jun 16, 2016

Last updated

Jun 16, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kimberly Asselin

Title

Ceo

Phone

(772) 214-1195

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466035200000",
    "number": "1689024085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "681 SW WHITMORE DR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349843567",
            "telephone_number": "772-214-1195",
            "fax_number": "772-382-0637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "681 SW WHITMORE DR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349843567",
            "telephone_number": "772-214-1195",
            "fax_number": "772-382-0637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY RECOVERY VILLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-16",
        "last_updated": "2016-06-16",
        "status": "A",
        "authorized_official_last_name": "ASSELIN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "772-214-1195"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "FL",
            "license": "APPLIED FOR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Substance Abuse Rehabilitation Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; 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.