SERENITY LANE (NPI# 1104934892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104934892 |
| Entity Type | Organization |
| Organization Name | SERENITY LANE |
| Practice Address |
1 Serenity Lane Coburg OR 97408 |
| Mailing Address |
P.o. Box 8549 1 Serenity Lane Coburg OR 97408 |
| Practice Telephone | 5412848605 |
| Practice Fax Number | 5416879041 |
| Mailing Telephone | 5412848605 |
| Mailing Fax Number | 5416879041 |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2017-04-24 |
| Authorized Official Name | MR. DUSTIN STAPLETON (VICE PRESIDENT OF FINANCE/ADMIN) |
| Authorized Official Telephone | 5412848617 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| 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 |
| 1689115891 | Serenity Lane | Case Management | 601 Nw Harmon Blvd, Bend, OR 97703-3060 | 2017-03-20 |
| 1073060182 | Serenity Lane | Counselor | 2575 Nw Kline St, Roseburg, OR 97471-8827 | 2016-09-07 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | SERENITY LANE | 1 Serenity Lane, Coburg, OR 97408 |
| 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 |
| Street Address |
1 SERENITY LANE |
| City | COBURG |
| State | OR |
| Zip Code | 97408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689114175 | Kenneth Boggie | Counselor | 1 Serenity Lane, Coburg, OR 97408 | 2017-03-02 |
| 1609328822 | Mindy Steury | Counselor | 1 Serenity Lane, Coburg, OR 97408 | 2016-11-04 |
| 1740736958 | Douglas Smith | Counselor | 1 Serenity Lane, Coburg, OR 97408 | 2016-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619575008 | Janna Marie Check | Physician Assistant | 3555 Chad Drive, Eugene, OR 97408 | 2020-10-16 |
| 1376181982 | Quentin Rowan | Counselor | 91150 Industrial Way, Coburg, OR 97408 | 2019-12-13 |
| 1659918621 | Nicholas Andrew Sparks | Counselor | 91150coburg Industrial Way, Coburg, OR 97408 | 2019-12-09 |
| 1629619267 | Suzan Marie Farr | Counselor | 91150 Coburg Industrial Lane, Coburg, OR 97408 | 2019-10-04 |
| 1629538608 | Shawn Michael Feddersen | Hearing Instrument Specialist | 1020 Green Acres Rd #8, Eugene, OR 97408 | 2019-03-25 |
| 1427513241 | Margaret Elizabeth Desroches | Registered Nurse | Delta Oaks Community Health Center, 1022 Green Acres Rd., Eugene, OR 97408 | 2019-02-06 |
| 1295218527 | Stephen Duane Sawyer | Counselor | 91150 N Coburg Industrial Way, Coburg, OR 97408 | 2018-09-12 |
| 1003339466 | Carly M. Peterschmidt, Dmd, LLC | Clinic/Center | 622 E 22nd Avenue, Suite A, Eugene, OR 97408 | 2017-07-18 |
| 1821549536 | Eugene Urgent Care | Clinic/Center | 1800 Coburg Rd., Eugene, OR 97408 | 2016-10-18 |
| 1851752232 | Nicole Marie Westbrook | Chiropractor | 90971 S Willamette St, Coburg, OR 97408 | 2016-03-14 |
| Find all providers in zip 97408 | ||||
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669000865 | Mid-valley Healthcare, Inc. | Substance Abuse Rehabilitation Facility | 111 N Main St Ste B, Lebanon, OR 97355-2869 | 2020-04-01 |
| 1548822216 | Oregon Recovery Behavioral Health | Substance Abuse Rehabilitation Facility | 1184 Mcgee Ct Ne Ste 200, Keizer, OR 97303-9443 | 2019-07-02 |
| 1972011682 | Women's Enrichment Counseling | Substance Abuse Rehabilitation Facility | 1300 John Adams St Ste 103, Oregon City, OR 97045-1691 | 2018-01-16 |
| 1356851042 | Debra Monaghan | Substance Abuse Rehabilitation Facility | 1271 Sw 9th St, Warrenton, OR 97146-9418 | 2017-10-06 |
| 1619429396 | Serenity Lane | Substance Abuse Rehabilitation Facility | 304 Dartmoor Drive, Eugene, OR 97401 | 2016-10-28 |
| 1043760838 | Pacific Crest Trail Detox LLC | Substance Abuse Rehabilitation Facility | 7708 Se Clackamas Rd, Milwaukie, OR 97267-4405 | 2016-10-05 |
| 1477002228 | Treehouse Nw Inc | Substance Abuse Rehabilitation Facility | 4713 N Albina Ave, Suite 301, Portland, OR 97217-2605 | 2016-09-21 |
| 1154785475 | Blvd Centers, Inc | Substance Abuse Rehabilitation Facility | 1316 Se 12th Ave, Portland, OR 97214-3604 | 2016-04-12 |
| 1851757454 | Circle of Trust Healing Center, LLC | Substance Abuse Rehabilitation Facility | 3300 Butler Creek Rd, Ashland, OR 97520-9173 | 2016-01-12 |
| 1700258258 | La Pine Ktc, LLC | Substance Abuse Rehabilitation Facility | 16161 Burgess Rd, La Pine, OR 97739-9533 | 2015-10-23 |
| Find all providers with the same taxonomy | ||||
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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.