| Serenity Lane | |
|
1 Serenity Lane Coburg OR 97408 | |
| (541) 284-8605 | |
| (541) 687-9041 |
| Full Name | Serenity Lane |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 1 Serenity Lane, Coburg, Oregon |
| Authorized Official Name and Position | Brian Carlin (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 5412848617 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Serenity Lane P.o. Box 8549 1 Serenity Lane Coburg OR 97408 Ph: (541) 284-8605 | Serenity Lane 1 Serenity Lane Coburg OR 97408 Ph: (541) 284-8605 |
| NPI Number | 1104934892 |
|---|---|
| Provider Enumeration Date | 08/25/2006 |
| Last Update Date | 04/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104934892 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Primary |