Provider Demographics
NPI:1396579819
Name:SWEET SERENITY THERAPY
Entity type:Organization
Organization Name:SWEET SERENITY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER SWEET SERENITY THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:TRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FARNSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:LMT,CMT
Authorized Official - Phone:605-484-4706
Mailing Address - Street 1:725 SAINT JOSEPH ST # B6
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-2720
Mailing Address - Country:US
Mailing Address - Phone:605-484-4706
Mailing Address - Fax:
Practice Address - Street 1:725 SAINT JOSEPH ST # B6
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-2720
Practice Address - Country:US
Practice Address - Phone:605-484-4706
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-27
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service