Organization
SERENITY TREATMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE R FITTING LMSW (SUPERVISOR)
(208) 743-5906
Entity
Organization
Contact information
Practice address
1229 MAIN ST STE 101, LEWISTON, ID 83501-6901
(208) 743-5906
(833) 264-6643
Mailing address
1229 MAIN ST STE 101, LEWISTON, ID 83501-6901
(208) 743-5906
(833) 264-6643
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-26273
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720414634
LCSW
ID
Enumeration date
06/26/2018
Last updated
06/26/2018
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