MEDICARE: JUST SERENITY INCORPORATED

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	251S00000X	Community/Behavioral Health Agency		TX

General Provider Information

NPI Number	:	1982049391
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUST SERENITY INCORPORATED

Provider Business Mailing Address
First Line	:	2115 RUNNELS ST APT 6203
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77003-1098
Country	:	US
Telephone Number	:	832-656-0046
Fax Number	:	713-485-4405

Provider Business Practice Location Address
First Line	:	2115 RUNNELS ST APT 6203
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77003-1098
Country	:	US
Telephone Number	:	832-656-0046
Fax Number	:	713-485-4405

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	AARON JARROD SMITH
Credential	:
Telephone Number	:	832-656-0046

Provider Enumeration Date	:	04/30/2013
Last Update Date	:	04/30/2013

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Directions to “JUST SERENITY INCORPORATED ” Practice Location

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