Organization
SERENITY LODGE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GILBERT YATES (CONTRACT MANAGER)
(877) 262-7803
Entity
Organization
Contact information
Practice address
341 CA-173, LAKE ARROWHEAD, CA 92352
(657) 304-0103
Mailing address
PO BOX 2895, LAKE ARROWHEAD, CA 92352-2895
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
01/31/2023
Last updated
10/01/2024
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