Healthcare Provider Details

I. General information

NPI: 1780590430
Provider Name (Legal Business Name): SERENE HORIZONS HEALTH, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2691 S 2000 W STE 3
REXBURG ID
83440-4089
US

IV. Provider business mailing address

2691 S 2000 W STE 3
REXBURG ID
83440-4089
US

V. Phone/Fax

Practice location:
  • Phone: 208-656-7444
  • Fax: 208-656-7464
Mailing address:
  • Phone: 208-656-7444
  • Fax: 208-656-7464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SHAREE HENDRICKS
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 208-656-7444