Serenity Path Inc.

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

1058815-1-CDT Issued in MN

Legal business name

SERENITY PATH INC.

Practice address

117 W James St
Box 3
Paynesville, MN 56362-1216

Phone

(320) 243-3379

NPI assigned

Jan 11, 2011

Organization subpart

No

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

Authorized official

Name

Mr. William Madigan, MS, LADC, BCCR

Title

Executive Director

Phone

(320) 243-3379

Specialties & licenses 1

Addresses

Tax ID family

Serenity Path Brooten2 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.

• Serenity Path Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Brooten, MN
  • NPI 1174926844
  NPD tax ID

Practitioners 1

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

• Brandy Lee Schade

  • Peer Specialist
  • Paynesville, MN
  • NPI 1275105462
  NPD (past)

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

{
    "created_epoch": "1294704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294704000000",
    "number": "1932404688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W JAMES ST",
            "address_2": "BOX 3",
            "city": "PAYNESVILLE",
            "state": "MN",
            "postal_code": "563621216",
            "telephone_number": "320-243-3379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W JAMES ST",
            "address_2": "BOX 3",
            "city": "PAYNESVILLE",
            "state": "MN",
            "postal_code": "563621216",
            "telephone_number": "320-243-3379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY PATH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-11",
        "last_updated": "2011-01-11",
        "status": "A",
        "authorized_official_last_name": "MADIGAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "320-243-3379",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS, LADC, BCCR"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MN",
            "license": "1058815-1-CDT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Recovery Center LLC
• Sarah Jane Revermann, APRN, CNP
• Erin Salo, PHARMD
• Brandy Lee Schade
• Rebecca Lee Schmitt
• Amanda Nicole Smith, PHARMD
• Sejin Shane Song, DDS
• Courtney Erin Stenger, DC
• Joseph Walter Stephanie, CRNA
• Lawrence Gordon Strate, M.D.,

• Substance Use Disorder Rehabilitation Clinic/Center in Paynesville, MN
• Providers in Paynesville, MN by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; 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.