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Organization

MI SERENITY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TEDDY EUGENE RUTH (CEO)
(573) 368-4899
Entity
Organization

Contact information

Practice address
11840 PRIVATE DRIVE 5136, ROLLA, MO 65401-5909
(573) 368-4899
Mailing address
11840 PRIVATE DRIVE 5136, ROLLA, MO 65401-5909
(573) 368-4899

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Enumeration date
11/19/2007
Last updated
11/19/2007
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