Healthcare Provider Details

I. General information

NPI: 1194665166
Provider Name (Legal Business Name): SERENE MENTAL HEALTH CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2817 ANTHONY LN S STE 200
MINNEAPOLIS MN
55418-2490
US

IV. Provider business mailing address

3182 CLEVELAND AVE N
ARDEN HILLS MN
55112-3505
US

V. Phone/Fax

Practice location:
  • Phone: 651-332-3817
  • Fax: 218-484-7773
Mailing address:
  • Phone: 651-332-3817
  • Fax: 218-484-7773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. JOHN IKECHUKWU NWABUGWU
Title or Position: CLINICAL DIRECTOR
Credential: PMHNP-BC
Phone: 651-332-3817