Healthcare Provider Details

I. General information

NPI: 1881571560
Provider Name (Legal Business Name): SERENE CHALET LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2025
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2209 VICTORIA LN
RICHARDSON TX
75082-4719
US

IV. Provider business mailing address

5900 BALCONES DR # 22467
AUSTIN TX
78731-4257
US

V. Phone/Fax

Practice location:
  • Phone: 972-806-2241
  • Fax:
Mailing address:
  • Phone: 972-806-2241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State

VIII. Authorized Official

Name: COLUMBIA JENEINE MITCHELL
Title or Position: MANAGER
Credential: RN
Phone: 214-718-5683