MEDICARE: SERENITY OF LIFE

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1831439322
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITY OF LIFE

Provider Business Mailing Address
First Line	:	333 HOPEDALE AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-6123
Country	:	US
Telephone Number	:	702-255-1849
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 HOPEDALE AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-6123
Country	:	US
Telephone Number	:	702-255-1849
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. KRISTINA MOORE-SWIFT
Credential	:
Telephone Number	:	702-672-6657

Provider Enumeration Date	:	02/21/2013
Last Update Date	:	02/22/2013

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Directions to “SERENITY OF LIFE ” Practice Location

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