MEDICARE: SERENITY INTEGRATIVE PSYCHIATRIC CARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1659067205
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITY INTEGRATIVE PSYCHIATRIC CARE INC

Provider Business Mailing Address
First Line	:	319 S 17TH ST STE 238
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68102-2040
Country	:	US
Telephone Number	:	402-819-7915
Fax Number	:	862-263-9115

Provider Business Practice Location Address
First Line	:	319 S 17TH ST STE 238
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68102-2040
Country	:	US
Telephone Number	:	402-819-7915
Fax Number	:	862-263-9115

Authorized Official
Title or Position	:	PMHNP
Name	:	MS. CHRISTINA NICOLE HADLEY
Credential	:	APRN
Telephone Number	:	402-651-6817

Provider Enumeration Date	:	04/17/2023
Last Update Date	:	01/27/2025

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