Provider Demographics
NPI:1184963126
Name:SERENE MENTAL HEALTH CLINIC LLC
Entity type:Organization
Organization Name:SERENE MENTAL HEALTH CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:GIERHAN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:308-233-3847
Mailing Address - Street 1:3615 2ND AVE STE A
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-8115
Mailing Address - Country:US
Mailing Address - Phone:308-233-3847
Mailing Address - Fax:308-233-5921
Practice Address - Street 1:3615 2ND AVE STE A
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-8115
Practice Address - Country:US
Practice Address - Phone:308-233-3847
Practice Address - Fax:308-233-5921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-12
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NENA2330Medicare PIN