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General NPI Number Information
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NPI Number | 1891184735
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Entity Type | Organization
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Legal Business Name | SERENITY OUTPATIENT SERVICES
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Dates
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Enumeration Date | 01/15/2015
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Last Update Date | 01/15/2015
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Provider Practice Location Address
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Address Line | 4332 CENTRAL AVE SUITE O
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City | HOT SPRINGS
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State | AR
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Zip | 71913-7437
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Country | US
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Telephone | 501-539-4940
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Fax | 501-421-9494
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Provider Business Mailing Address
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Address Line | 330 BURCHWOOD BAY RD #G72
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City | HOT SPRINGS
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State | AR
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Zip | 71913-7184
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Country | US
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Telephone | 501-539-3713
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Fax | 501-421-9494
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Authorized Official
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Title or Position | OWNER
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Name | LAURA APRIL COMBS
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Credential | LCSW
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Telephone | 501-539-3713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 3590-C
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License Number State | AR
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