Healthcare Provider Details

I. General information

NPI: 1275360083
Provider Name (Legal Business Name): SERENITY HEALTHCARE OF LAS CRUCES,LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2024
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 W LAS CRUCES AVE
LAS CRUCES NM
88005-1804
US

IV. Provider business mailing address

1338 PARK DR CAROLINE BARRETT
LAS CRUCES NM
88005
US

V. Phone/Fax

Practice location:
  • Phone: 575-288-9994
  • Fax: 575-525-3703
Mailing address:
  • Phone: 360-720-4374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: CAROLINE A BARRETT
Title or Position: OWNER
Credential: FNP-BC
Phone: 360-720-4374