=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780590430
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SERENE HORIZONS HEALTH, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/21/2026
-----------------------------------------------------
Last Update Date | 08/21/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2691 S 2000 W STE 3
-----------------------------------------------------
City | REXBURG
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83440-4089
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-656-7444
-----------------------------------------------------
Fax | 208-656-7464
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2691 S 2000 W STE 3
-----------------------------------------------------
City | REXBURG
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83440-4089
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-656-7444
-----------------------------------------------------
Fax | 208-656-7464
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | SHAREE HENDRICKS
-----------------------------------------------------
Credential | PMHNP-BC
-----------------------------------------------------
Telephone | 208-656-7444
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------