Contract Details
Ancillary Care Services
Facility name
Serenity Rehab and Wellness Center
Provider ID
P000005776
NPI
1992028104
Tax ID
201649609
Effective Date
4/1/2012
Last Updated
10/17/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
3795 East North Street Suite 14
Greenville, SC 29615
United States
County
Greenville
Phone
8642920011 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address