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General NPI Number Information
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NPI Number | 1174483440
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Entity Type | Organization
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Legal Business Name | THE SERENITY PASSAGE LLC
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Dates
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Enumeration Date | 11/17/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 1202 1ST ST E UNIT 1561
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City | HUMBLE
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State | TX
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Zip | 77347-7075
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Country | US
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Telephone | 346-347-6011
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Fax |
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Provider Business Mailing Address
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Address Line | 1202 1ST ST E UNIT 1561
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City | HUMBLE
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State | TX
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Zip | 77347-7075
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Country | US
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Telephone | 346-347-6011
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICOSHA HALL
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Credential |
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Telephone | 346-347-6011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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