Provider Demographics
NPI:1851286439
Name:THE SERENE SANCTUARY LLC
Entity type:Organization
Organization Name:THE SERENE SANCTUARY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:317-279-5045
Mailing Address - Street 1:7022 W 10TH ST SUIT A #1028
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46214
Mailing Address - Country:US
Mailing Address - Phone:317-279-5045
Mailing Address - Fax:
Practice Address - Street 1:101 N UNION STREET
Practice Address - Street 2:UNIT 507
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46901
Practice Address - Country:US
Practice Address - Phone:317-279-5045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty