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General NPI Number Information
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NPI Number | 1437889870
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Entity Type | Organization
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Legal Business Name | SERENITY HEALTHCARE SERVICES, PLLC
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Dates
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Enumeration Date | 06/16/2022
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Last Update Date | 06/16/2022
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Provider Practice Location Address
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Address Line | 1505 HIGHWAY 6 S STE 215
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City | HOUSTON
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State | TX
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Zip | 77077-1700
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Country | US
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Telephone | 928-256-5094
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Fax | 928-504-0152
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Provider Business Mailing Address
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Address Line | 1394 W 16TH ST
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City | YUMA
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State | AZ
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Zip | 85364-4430
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Country | US
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Telephone | 928-256-5094
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Fax | 928-504-0152
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Authorized Official
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Title or Position | OWNER
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Name | SIDONIE NGANKEU
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Credential |
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Telephone | 928-256-5094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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