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
JESSE LEE KELLERT (CEO)
(949) 244-2279
Entity
Organization
Contact information
Practice address
27175 STATE HIGHWAY 189, UNIT A, BLUE JAY, CA 92317
(949) 244-2279
Mailing address
PO BOX 2895, LAKE ARROWHEAD, CA 92352-2895
(949) 244-2279
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
08/13/2026
Last updated
08/13/2026
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