Provider Demographics
NPI:1316319650
Name:SERENITY CENTER
Entity type:Organization
Organization Name:SERENITY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-205-7977
Mailing Address - Street 1:4200 PERIMETER CENTER DR
Mailing Address - Street 2:SUITE 125
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-2324
Mailing Address - Country:US
Mailing Address - Phone:405-605-5810
Mailing Address - Fax:405-605-5815
Practice Address - Street 1:4200 PERIMETER CENTER DR
Practice Address - Street 2:SUITE 125
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-2324
Practice Address - Country:US
Practice Address - Phone:405-605-5810
Practice Address - Fax:405-605-5815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-27
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health