| Organization Name: | SERENITY PATH INC. |
| NPI Number: | 1932404688 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM MADIGAN (EXECUTIVE DIRECTOR) |
| Mailing Address: | 117 W James St Box 3 Paynesville |
| State: | MN US |
| Postal Code: | 563621216 |
| Phone Number: | 3202433379 |
| Fax Number: | |
| NPI Enumeration Date: | 01/11/2011 |
| NPI Last Update Date: | 01/11/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0405X |
| License Number: | 1058815-1-CDT |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
| Taxonomy Definition: | |