Organization
SERENITY LODGE, INC
Active
Parent organization
SERENITY LODGE, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SERENITY LODGE, INC
Authorized official
MATTHEW JOSEPH BALDO (COMPLIANCE MANAGER)
(909) 693-5127
Entity
Organization
Contact information
Practice address
1010 MEADOW BROOK ROAD, LAKE ARROWHEAD, CA 92352
(909) 693-5127
Mailing address
PO BOX 2895, LAKE ARROWHEAD, CA 92352-2895
(909) 693-5127
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
12/03/2018
Last updated
12/03/2018
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