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Organization
SERENITY HOUSE PCH, INC.
Active
Organization
SERENITY HOUSE PCH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEIDRE COBB TIFT LMSW, RNC (PRESIDENT)
(912) 977-4643
Entity
Organization
Contact information
Practice address
210 GARDEN CIR, HINESVILLE, GA 31313-4421
(912) 977-4663
(912) 369-6530
Mailing address
210 GARDEN CIR, HINESVILLE, GA 31313-4421
(912) 977-4663
(912) 369-6530
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
080640
MI
106H00000X
Marriage & Family Therapist
Primary
MSW002656
GA
Other
Enumeration date
09/23/2010
Last updated
09/30/2010
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