Provider Demographics
NPI:1437889870
Name:SERENITY HEALTHCARE SERVICES, PLLC
Entity Type:Organization
Organization Name:SERENITY HEALTHCARE SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIDONIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NGANKEU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-256-5094
Mailing Address - Street 1:1394 W 16TH ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-4430
Mailing Address - Country:US
Mailing Address - Phone:928-256-5094
Mailing Address - Fax:928-504-0152
Practice Address - Street 1:1505 HIGHWAY 6 S STE 215
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-1700
Practice Address - Country:US
Practice Address - Phone:928-256-5094
Practice Address - Fax:928-504-0152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty