Organization
SERENITY HOUSE PCH, INC.
Active
Organization
SERENITY HOUSE PCH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEIDRE C TIFT LMSW, RNC (PRESIDENT)
(912) 977-4643
Entity
Organization
Contact information
Practice address
36 COATES RD, HINESVILLE, GA 31313-1013
(912) 877-7958
(912) 369-6530
Mailing address
36 COATES RD, HINESVILLE, GA 31313-1013
(912) 877-7958
(912) 369-6530
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
012789
MI
1041C0700X
Clinical Social Worker
Primary
MSW002656
GA
1041C0700X
Clinical Social Worker
MSW003123
GA
Other
Enumeration date
08/16/2010
Last updated
08/16/2010
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