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General NPI Number Information
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NPI Number | 1033917950
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Entity Type | Organization
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Legal Business Name | SERENITY HOLISTIC HEALING LLC
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Dates
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Enumeration Date | 03/05/2025
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 101 REDTAIL DR STE A
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City | ASHLAND
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State | MO
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Zip | 65010-1140
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Country | US
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Telephone | 609-680-1416
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Fax |
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Provider Business Mailing Address
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Address Line | 2919 STATE ROAD AA
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City | HOLTS SUMMIT
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State | MO
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Zip | 65043-1208
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Country | US
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Telephone | 609-680-1416
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MARY ROSARIO
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Credential | LMT
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Telephone | 609-680-1416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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