| NPI | 1447014410 |
|---|---|
| Former Legal Business Name | SERENITY NORTHSHORE |
| Entity Type | Organization |
| Authorized Contact | ERIC DAVID MCVICKER Owner 202-674-2337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-02-09 |
| Last Update Date | 2024-02-09 |