SERENITY LANE


Address: 2575 Nw Kline St, Roseburg, OR 97471-8827
Phone: 5416733504

SERENITY LANE (NPI# 1073060182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1073060182
Entity Type Organization
Organization Name SERENITY LANE
Practice Address 2575 Nw Kline St
Roseburg
OR 97471-8827
Practice Telephone 5416733504
Practice Fax Number 5416734724
Mailing Telephone 5416733504
Mailing Fax Number 5416734724
Enumeration Date 2016-09-07
Last Update Date 2016-09-07
Authorized Official Name MR. ANTHONY WILLIAM HAYNES (PROGRAM COORDINATOR)
Authorized Official Telephone 5416733504
Authorized Official Credential BS CADCII
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
13-12-59 OR Behavioral Health & Social Service Providers

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1619429396 Serenity Lane Substance Abuse Rehabilitation Facility 304 Dartmoor Drive, Eugene, OR 97401 2016-10-28
1710330386 Serenity Lane Counselor 2575 Nw Kline St, Roseburg, OR 97471-8827 2016-07-19
1104934892 Serenity Lane Substance Abuse Rehabilitation Facility 1 Serenity Lane, Coburg, OR 97408 2006-08-25
1689115891 Serenity Lane Case Management 601 Nw Harmon Blvd, Bend, OR 97703-3060 2017-03-20

Other Data Sources

Entity Type Entity Name Entity Address
Oregon Corporations, Companies and Business Names SERENITY LANE 1 Serenity Lane, Coburg, OR 97408
New York State Corporations SERENITY LANE CORP. 2067 Berme Road, Kerhonkson, Ny 12446
Oregon Corporations, Companies and Business Names SERENITY LANE HEALTH SERVICES 1 Serenity Lane, Coburg, OR 97408
Oregon Corporations, Companies and Business Names SERENITY LANE HEALTH SERVICES FOUNDATION 1 Serenity Lane, Coburg, OR 97408

Office Location

Street Address 2575 NW KLINE ST
City ROSEBURG
State OR
Zip Code 97471-8827

Providers in the same location

NPI Name Taxonomy Address Enumeration
1710330386 Serenity Lane Counselor 2575 Nw Kline St, Roseburg, OR 97471-8827 2016-07-19
1114530193 Lydia Corine Meyer Counselor 2575 Nw Kline St, Roseburg, OR 97471-8827 2020-08-28
1316594427 Todd Allyn Bryson Counselor 2575 Nw Kline St, Roseburg, OR 97471-8827 2019-08-22
1477109122 Michelle Wissel Counselor 2575 Nw Kline St, Roseburg, OR 97471-8827 2019-08-16
1962058883 Samantha Hardy Counselor 2575 Nw Kline St, Roseburg, OR 97471-8827 2019-08-15
1326568189 George Charles Spurny Counselor 2575 Nw Kline St, Roseburg, OR 97471-8827 2017-06-22
1972053205 Anthony Haynes Counselor 2575 Nw Kline St, Roseburg, OR 97471-8827 2016-10-11
1467905489 Kay Tanner Counselor 2575 Nw Kline St, Roseburg, OR 97471-8827 2016-07-26

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1841805660 Rae Ann Barnes Pharmacist 913 Ne Garden Valley Blvd, Pharmacy, Roseburg, OR 97471 2020-09-09
1023651031 Colton Phillips Behavioral Analyst 940 Nw Garden Valley Bvld #104, Roseburg, OR 97471 2019-10-22
1952884876 Meredith Krugel Lcsw PC Clinic/Center 2225 Nw Stewart Parkway Ste 200, Roseburg, OR 97471 2018-09-07
1114456563 Philip Kaser Family, LLC Pharmacy 1175 W. Harvard Avenue, Roseburg, OR 97471 2017-06-08
1053854208 Icco LLC Clinic/Center 1740 Nw Goetz Street, Roseburg, OR 97471 2016-11-21
1770034589 Evie Jepsen Case Manager/Care Coordinator 2700 Stewart Parkway Annex B, Suite 110, Roseburg, OR 97471 2016-10-17
1932551256 Jonathan Schmidt Licensed Practical Nurse 913 Nm Garden Valley Blvd, Va Roseburg Medical Center, Roseburg, OR 97471 2016-07-11
1932580586 Jeffrey Mark Wareham Case Manager/Care Coordinator 2700 Medical Loop, Annex B, Roseburg, OR 97471 2015-06-09
1558784215 Ginger Jean Thibedeau Massage Therapist 3019 Nw Stewart Parkway, Suite 304 #183, Roseburg, OR 97471 2014-01-30
1427303122 Karishma Parekh Internal Medicine 2460 Nw Stewart Pkwy Ste 103, Roseburg, OR 97471 2012-07-18
Find all providers in zip 97471

Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1710330386 Serenity Lane Counselor 2575 Nw Kline St, Roseburg, OR 97471-8827 2016-07-19
1306205984 Susan Anne Dowell Counselor 548 Se Jackson Street, Roseburg, OR 97470-0254 2016-02-11
1528426517 William C. Poulter Counselor 548 Sw Jackson St, Roseburg, OR 97470-2709 2016-02-04
1508295668 Adapt Counselor 1215 Se Court Ave, Roseburg, OR 97470-4329 2013-11-08
1174952238 Adapt Counselor 550 Se Jackson St, Roseburg, OR 97470-4923 2013-11-08
1639508708 Adapt Counselor 1036 Se Douglas Ave, Roseburg, OR 97470-3301 2013-11-08
1245597582 Alison Marie Hinson Counselor 850 Se Rose St, Roseburg, OR 97470-3942 2012-04-11
1114112133 Delila S Donaldson Counselor 727 Se Cass Ave Ste 223, Roseburg, OR 97470-4953 2007-09-12
1639256431 Linda Witbeck Counselor 913 Garden Valley Blvd, Bldg 2, Ward 2, Sartp, Roseburg, OR 97470 2006-11-01
1750373346 Adapt Counselor 548 Se Jackson St, Roseburg, OR 97470-4983 2005-08-18
Find all providers in ROSEBURG

Competitor

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City ROSEBURG
Zip Code 97471

Improve Information

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Dataset Information

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.

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