MEDICARE: SERENITY FAMILY CONNECTIONS, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	261QM0850X	Adult Mental Health Clinic/Center
3	261QM0855X	Adolescent and Children Mental Health Clinic/Center
4	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1922821602
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITY FAMILY CONNECTIONS, PLLC

Provider Business Mailing Address
First Line	:	281 W 24TH ST STE 135
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-8587
Country	:	US
Telephone Number	:	928-581-4911
Fax Number	:

Provider Business Practice Location Address
First Line	:	281 W 24TH ST STE 135
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-8587
Country	:	US
Telephone Number	:	928-581-4911
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	JOSEPHINA CAMACHO GARCIA
Credential	:	MA, LMFT
Telephone Number	:	928-581-4911

Provider Enumeration Date	:	11/01/2024
Last Update Date	:	11/01/2024

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