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General NPI Number Information
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NPI Number | 1851286439
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Entity Type | Organization
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Legal Business Name | THE SERENE SANCTUARY LLC
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Dates
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Enumeration Date | 06/12/2025
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 101 N UNION STREET UNIT 507
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City | KOKOMO
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State | IN
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Zip | 46901
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Country | US
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Telephone | 317-279-5045
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Fax |
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Provider Business Mailing Address
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Address Line | 7022 W 10TH ST SUIT A #1028
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City | INDIANAPOLIS
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State | IN
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Zip | 46214
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Country | US
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Telephone | 317-279-5045
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SARA SPENCE
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Credential | PMHNP
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Telephone | 317-279-5045
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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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