SERENITY KNOLLS, INC. (NPI# 1831337534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831337534 |
| Entity Type | Organization |
| Organization Name | SERENITY KNOLLS, INC. |
| Practice Address |
145 Tamal Road Forest Knolls CA 94933 |
| Mailing Address |
6100 Tower Cir Ste 1000 Franklin TN 37067-1509 |
| Practice Telephone | 4154880400 |
| Practice Fax Number | 4154881955 |
| Mailing Telephone | 6158616000 |
| Enumeration Date | 2009-02-03 |
| Last Update Date | 2018-10-15 |
| Authorized Official Name | CHRISTOPHER HOWARD (VP & TREASURER) |
| Authorized Official Telephone | 6158616000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 210011AP | CA | Residential Treatment Facilities |
| Street Address |
145 TAMAL ROAD |
| City | FOREST KNOLLS |
| State | CA |
| Zip Code | 94933 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396726626 | Serenity Knolls | Clinic/Center | 145 Tamal Road, Forest Knolls, CA 94933 | 2005-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669917399 | George A Peterson | Psychologist | Po Box P, 20 Sanchez Rd Ste P, Forest Knolls, CA 94933-0713 | 2017-01-04 |
| 1760617948 | Nancy Jean Carlyle | Registered Nurse | 15 Aztec Ave., Forest Knolls, CA 94933-0783 | 2009-05-18 |
| 1124580972 | Marcia Bradley Branca | Marriage & Family Therapist | 87 Aztec Avenue, Forest Knolls, CA 94933-0819 | 2019-04-02 |
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
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| City | FOREST KNOLLS |
| Zip Code | 94933 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.