Provider Demographics
NPI:1154194223
Name:SERENITY HOUSE OF ATLANTA MINISTRIES INC.
Entity type:Organization
Organization Name:SERENITY HOUSE OF ATLANTA MINISTRIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BETHEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-473-7364
Mailing Address - Street 1:1041 KINNETT RD
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-9163
Mailing Address - Country:US
Mailing Address - Phone:844-473-7364
Mailing Address - Fax:
Practice Address - Street 1:1041 KINNETT RD
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30016-9163
Practice Address - Country:US
Practice Address - Phone:844-473-7364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility