SERENITY HOUSE, INC. (NPI# 1144432907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144432907 |
| Entity Type | Organization |
| Organization Name | SERENITY HOUSE, INC. |
| Practice Address |
30 Mellen St Portland ME 04101-2110 |
| Practice Telephone | 2077742722 |
| Practice Fax Number | 2077748780 |
| Mailing Telephone | 2077742722 |
| Mailing Fax Number | 2077748780 |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2009-06-10 |
| Authorized Official Name | MR. ROBERT DAWBER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2077742722 |
| Authorized Official Credential | M.ED |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 257921 | ME | Residential Treatment Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SERENITY HOUSE, INC | 891 S State Rte 53, Addison, IL 60101-4220 |
| Street Address |
30 MELLEN ST |
| City | PORTLAND |
| State | ME |
| Zip Code | 04101-2110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306450655 | Jocylin Egan | Nurse Practitioner | 442 Congress Street, 2nd Floor, Portland, ME 04101 | 2020-09-03 |
| 1255963559 | Portcity Home Healthcare LLC | In Home Supportive Care | 525 Forest Avenue, Suite 8, Portland, ME 04101 | 2020-02-05 |
| 1578101929 | Mohamed Hassan Mohamed | Student in an Organized Health Care Education/Training Program | 75 Lancaster St Ste 218a, Portland, ME 04101 | 2019-12-17 |
| 1841855301 | Portland Opioid Health Home | Counselor | 48 Free St., Mezzanine Level, Portland, ME 04101 | 2019-05-09 |
| 1093379224 | Alexandra Strawbridge Maurer | Acupuncturist | 50 A Cove Street, Portland, ME 04101 | 2019-04-23 |
| 1245719541 | Scott J Whited | Nurse Practitioner | 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 | 2018-08-08 |
| 1144733064 | Alixandria Elaine Marie Winchell | Massage Therapist | One City Center, Portland, ME 04101 | 2017-11-14 |
| 1417473638 | Rachel S Schwaner | Occupational Therapist | 78 Danforth Street, Apartment 6, Portland, ME 04101 | 2017-08-18 |
| 1023538154 | Derina Boothroyd | Audiologist-Hearing Aid Fitter | 985 Forest Ave., Portland, ME 04101 | 2017-06-20 |
| 1881123297 | Mark Mccullough | Social Worker | 57 Exchange Street, Suite 403, Portland, ME 04101 | 2017-06-08 |
| Find all providers in zip 04101 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1104219211 | Allied Health Services | Substance Abuse Rehabilitation Facility | 808 Se Alder St, Portland, OR 97214-2213 | 2015-03-13 |
| 1700297074 | Pathfinders of Oregon | Substance Abuse Rehabilitation Facility | 7800 Sw Barbur Blvd, Portland, OR 97219-2823 | 2014-05-08 |
| 1194037283 | De Paul Treatment Centers | Substance Abuse Rehabilitation Facility | 1312 Sw Washington St., Portland, OR 97208 | 2010-07-06 |
| 1649412511 | Portland Detox | Substance Abuse Rehabilitation Facility | 11160 Sw Waverly Pl, Portland, OR 97225-4456 | 2009-03-24 |
| 1063548436 | Milestone Foundation Inc | Substance Abuse Rehabilitation Facility | 65 India St, Portland, ME 04101-4209 | 2007-02-27 |
| 1851428775 | Depaul Treatment Centers Inc. | Substance Abuse Rehabilitation Facility | 5052 Ne 42nd Ave, Portland, OR 97218-1550 | 2007-02-27 |
| 1114546645 | Nw Insituto Latino | Substance Abuse Rehabilitation Facility | 2054 N Vancouver Ave, Portland, OR 97227-1917 | 2020-04-14 |
| 1730673088 | Pine Tree Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 17 Bishop St, Portland, ME 04103-2659 | 2018-06-20 |
| Find all providers in PORTLAND | ||||
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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.