Serenitymed Recovery, LLC
Nurse Practitioner, Family in Atlanta, GA. Organization (NPI-2).
NPI number1093494841
StatusActive
Last updated in NPPESJan 6, 2025
Details
- NPI
- 1093494841
- Entity type
- Organization (NPI-2)
- Legal business name
- Serenitymed Recovery, LLC
- Organization subpart
- No
- Enumeration date
- Jul 17, 2023
- Certification date
- Jan 6, 2025
- Last updated
- Jan 6, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | – | – | Yes |
Practice location
1954 Airport Rd # 670Atlanta, GA 30341-4956
Phone 678-250-4659 · Fax 404-868-5162
Mailing address
4027 Caitlyn PlDoraville, GA 30360-3225
Phone 404-451-7529 · Fax 404-868-5162
Authorized official
Erica Chanise Bolar
Owner
6782504659
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