Healthcare Provider Details

I. General information

NPI: 1447731146
Provider Name (Legal Business Name): SERENITY BIRTH CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2018
Last Update Date: 08/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 S. JONES BLVD
LAS VEGAS NV
89107
US

IV. Provider business mailing address

332 S. JONES BLVD
LAS VEGAS NV
89107
US

V. Phone/Fax

Practice location:
  • Phone: 702-269-6018
  • Fax: 702-269-6081
Mailing address:
  • Phone: 702-269-6018
  • Fax: 702-269-6081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. APRIL CLYDE
Title or Position: OWNER/APRN
Credential: APRN
Phone: 702-269-6018