MEDICARE: SERENITY BEHAVIOR CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1619838190
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITY BEHAVIOR CENTER LLC

Provider Business Mailing Address
First Line	:	1500 N GRANT ST STE 6345
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-1752
Country	:	US
Telephone Number	:	970-812-3526
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 N GRANT ST STE 6345
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-1752
Country	:	US
Telephone Number	:	970-812-3526
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	OSSIRIS AVILA
Credential	:	MS, BCBA
Telephone Number	:	970-201-4723

Provider Enumeration Date	:	11/24/2025
Last Update Date	:	03/02/2026

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