Organization
SERENITY SPRINGS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN PIKE (DIRECTOR OF OPERATIONS)
(386) 423-4540
Entity
Organization
Contact information
Practice address
1555 COW CREEK RD, EDGEWATER, FL 32132-6915
(386) 423-4540
Mailing address
1555 COW CREEK RD, EDGEWATER, FL 32132-6915
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
0764AD596801
FL
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113733600
—
FL
01
—
69-3200
CMS
FL
01
—
69-3200
MEDICARE
—
Enumeration date
06/21/2013
Last updated
06/14/2023
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