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General NPI Number Information
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NPI Number | 1366207904
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Entity Type | Organization
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Legal Business Name | SERENITY BEHAVIORAL HEALTH PLLC
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Dates
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Enumeration Date | 02/13/2024
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 4801 176TH ST E APT K308
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City | TACOMA
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State | WA
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Zip | 98446-2847
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Country | US
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Telephone | 770-572-2098
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Fax |
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Provider Business Mailing Address
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Address Line | 4801 176TH ST E APT K308
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City | TACOMA
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State | WA
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Zip | 98446-2847
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Country | US
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Telephone | 770-572-2098
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CAROLINE NDUTA NDUATI
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Credential | NURSE PRACTITIONER
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Telephone | 770-572-2098
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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