SERENITY PATH INC. (NPI# 1932404688) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932404688 |
| Entity Type | Organization |
| Organization Name | SERENITY PATH INC. |
| Practice Address |
117 W James St Box 3 Paynesville MN 56362-1216 |
| Practice Telephone | 3202433379 |
| Mailing Telephone | 3202433379 |
| Enumeration Date | 2011-01-11 |
| Last Update Date | 2011-01-11 |
| Authorized Official Name | MR. WILLIAM MADIGAN (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3202433379 |
| Authorized Official Credential | MS, LADC, BCCR |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
1058815-1-CDT | MN | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174926844 | Serenity Path Inc. | Clinic/Center | 145 Central Ave S, Box 324, Brooten, MN 56316-4748 | 2014-10-08 |
| Street Address |
117 W JAMES ST BOX 3 |
| City | PAYNESVILLE |
| State | MN |
| Zip Code | 56362-1216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730709007 | Lisa Joy Klein-conrad | Counselor | 117 W James St, Paynesville, MN 56362-1216 | 2020-04-16 |
| 1083256002 | Lauren A Foster | Peer Specialist | 117 W James St, Paynesville, MN 56362-1216 | 2019-10-10 |
| 1417500612 | James Bernard Bruns Jr. | Counselor | 117 W James St, Paynesville, MN 56362-1216 | 2019-07-17 |
| 1770148009 | Shannon Swenson | Counselor | 117 W James St, Paynesville, MN 56362-1216 | 2019-05-02 |
| 1528623857 | Ronald Craig Swenson | Counselor | 117 W James St, Paynesville, MN 56362-1216 | 2019-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174055321 | Ginelle Rae Zimmerman | Family Medicine | 200 W 1st Street, Paynesville, MN 56362 | 2017-03-28 |
| 1710173877 | Jennifer Ann Klocker | Pharmacist | 200 West First Street, Paynesville, MN 56362 | 2007-09-21 |
| 1033322599 | Teresa Marie Winter | Massage Therapist | 750 State Hwy 55, Paynesville, MN 56362 | 2007-05-08 |
| 1336225838 | Donald Arther Millner | Dentist | 204 West James Street, Paynesville, MN 56362 | 2006-10-27 |
| 1760485908 | Todd D Lemke | Pharmacist | 200 First St W, Paynesville, MN 56362 | 2005-05-23 |
| 1700895604 | Daniel M Lillquist | Physician Assistant | 200 W 1st St, Paynesville, MN 56362 | 2006-08-07 |
| 1144288754 | Melissa Lynn Dols | Dietitian, Registered | 200 W 1st St, Paynesville, MN 56362 | 2006-05-03 |
| 1760440846 | Centracare Health - Paynesville LLC | Pharmacy | 200 W 1st St, Paynesville, MN 56362 | 2006-05-01 |
| 1275846487 | Paynesville Area Living At Home Block Nurse Program | Voluntary or Charitable | 1105 W Main St, Paynesville, MN 56362-1000 | 2010-07-16 |
| 1801420039 | Recovery Center LLC | Substance Abuse Rehabilitation Facility | 109 W James St, Paynesville, MN 56362-1216 | 2020-02-26 |
| Find all providers in zip 56362 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093340036 | Humble Recovery | Clinic/Center | 1156 Aldrich Ave N, Minneapolis, MN 55411-4248 | 2020-03-10 |
| 1366096307 | Centered On Youth | Clinic/Center | 3210 Oliver Ave N, Minneapolis, MN 55412-2316 | 2019-07-29 |
| 1881250785 | Adap Consulting | Clinic/Center | 1605 Southcross Dr W Ste B, Burnsville, MN 55306-7013 | 2019-05-15 |
| 1821550005 | Coscarelli Consulting, LLC | Clinic/Center | 1687 Woodlane Dr Ste 2002, Woodbury, MN 55125-3063 | 2019-04-04 |
| 1669943908 | Capital Health Services LLC | Clinic/Center | 680 Mendelssohn Ave N, Golden Valley, MN 55427-4306 | 2018-12-16 |
| 1013497916 | Thrive Behavioral Network Iv, LLC | Clinic/Center | 119 Friberg Ave, Suite B, Fergus Falls, MN 56537-2251 | 2018-08-20 |
| 1780186130 | Alliance Wellness Clinic Inc. | Clinic/Center | 8040 Old Cedar Ave. S. Ste. 100, Bloomington, MN 55425-1211 | 2018-03-01 |
| 1447795596 | Conceptual Counseling & Assessment | Clinic/Center | 151 W Burnsville Pkwy Ste 101, Burnsville, MN 55337-2525 | 2016-12-28 |
| 1871035568 | No Other Way (now) Recovery Services LLC | Clinic/Center | 1614 W 3rd St, Red Wing, MN 55066-2086 | 2016-11-11 |
| 1104374073 | Lakes Opioid Treatment Program, Inc | Clinic/Center | 8381 Lake Land Trl Nw, Walker, MN 56484-2109 | 2016-09-20 |
| Find all providers with the same taxonomy | ||||
| City | PAYNESVILLE |
| Zip Code | 56362 |
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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.