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General NPI Number Information
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NPI Number | 1417818733
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Entity Type | Organization
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Legal Business Name | SERENITY MEDSPA LLC
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Dates
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Enumeration Date | 11/18/2025
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 1707 LINWOOD DR STE B-1
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City | PARAGOULD
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State | AR
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Zip | 72450-5364
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Country | US
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Telephone | 870-558-6629
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Fax | 888-977-2956
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Provider Business Mailing Address
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Address Line | 1707 LINWOOD DR STE B-1
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City | PARAGOULD
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State | AR
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Zip | 72450-5364
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Country | US
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Telephone | 870-558-6629
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Fax | 888-977-2956
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Authorized Official
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Title or Position | DIRECTOR OF ACCOUNTS
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Name | HEATHER MCQUAY
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Credential | MSHCM
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Telephone | 870-604-4455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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