SERENITY GROVE L.L.C. NPI 1811442312

NPI Information

  • NPI: 1811442312
  • Provider Name: SERENITY GROVE, L.L.C.
  • Classification: Substance Abuse Rehabilitation Facility - 324500000X
  • Entity Type: Organization
  • CLIA Number: 11D2117647
  • Address: 1021 PARKSIDE CMNS
    SUITE 104
    GREENSBORO, GA
    ZIP 30642
  • Phone: (706) 389-5157

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NPI Details

SERENITY GROVE, L.L.C. is a substance abuse rehabilitation facility in Greensboro, GA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. SERENITY GROVE, L.L.C. NPI is 1811442312. The provider is registered as an organization entity type.

The provider's business location address is:

1021 PARKSIDE CMNS
SUITE 104
GREENSBORO, GA
ZIP 30642-521
Phone: (706) 389-5157
Fax: (706) 353-1510

The provider's authorized official is Jerry N Veal .
The authorized official title is Administrator and has the following contact phone number (706) 389-5157.

The CLIA number assigned to this NPI record is 11D2117647 - other - iop & addiction treatent with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/25/2016 and was last updated on 8/25/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1324500000XSubstance Abuse Rehabilitation FacilityYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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