Healthcare Provider Details

I. General information

NPI: 1205423464
Provider Name (Legal Business Name): SERENITY PSYCHIATRIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2020
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PROSPECT AVE
HOT SPRINGS AR
71901-4003
US

IV. Provider business mailing address

PO BOX 22114
HOT SPRINGS AR
71903-2114
US

V. Phone/Fax

Practice location:
  • Phone: 501-625-2443
  • Fax:
Mailing address:
  • Phone: 501-625-2443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LISA D TINNEY
Title or Position: OWNER
Credential:
Phone: 501-609-2222