Provider Demographics
NPI:1629395785
Name:SERENITY CENTER FOR DEPRESSION
Entity Type:Organization
Organization Name:SERENITY CENTER FOR DEPRESSION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TMS TECH
Authorized Official - Prefix:
Authorized Official - First Name:ROXANE
Authorized Official - Middle Name:K
Authorized Official - Last Name:ZOTYKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-240-4322
Mailing Address - Street 1:4545 SWEETWATER BLVD
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3010
Mailing Address - Country:US
Mailing Address - Phone:281-240-4322
Mailing Address - Fax:281-240-7017
Practice Address - Street 1:4545 SWEETWATER BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3010
Practice Address - Country:US
Practice Address - Phone:281-240-4322
Practice Address - Fax:281-240-7017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5278323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility