Organization
SERENITY MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HATTIE FIELDS RN (ADMINISTRATOR)
(843) 554-0733
Entity
Organization
Contact information
Practice address
4018 S RHETT AVE, N CHARLESTON, SC 29405-7163
(843) 554-0733
Mailing address
PO BOX 21934, CHARLESTON, SC 29413-1934
(843) 554-0733
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
12184-C07
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RC1472
—
SC
Enumeration date
06/24/2013
Last updated
06/24/2013
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