Provider Demographics
NPI:1518850940
Name:RENEW SERENITY MENTAL HEALTH & WELLNESS LLC
Entity type:Organization
Organization Name:RENEW SERENITY MENTAL HEALTH & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSH
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:317-721-9035
Mailing Address - Street 1:9783 E 116TH ST STE 336
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-2822
Mailing Address - Country:US
Mailing Address - Phone:317-721-9035
Mailing Address - Fax:317-934-6467
Practice Address - Street 1:11 MUNICIPAL DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038
Practice Address - Country:US
Practice Address - Phone:317-721-9035
Practice Address - Fax:317-934-6467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty