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General NPI Number Information
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NPI Number | 1972466597
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Entity Type | Organization
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Legal Business Name | SERENITY RESIDENTIAL SERVICES LLC
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 820 HUNTERS GLN
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City | MURPHY
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State | TX
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Zip | 75094-4375
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Country | US
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Telephone | 614-602-7035
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Fax |
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Provider Business Mailing Address
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Address Line | 809 WOODBRIDGE PKWY STE 500
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City | WYLIE
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State | TX
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Zip | 75098-7151
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Country | US
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Telephone | 614-602-7035
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Fax |
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Authorized Official
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Title or Position | OWNER/ ADMINISTRATOR
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Name | ASIYA MOHAMED
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Credential |
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Telephone | 614-602-7035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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