Provider Demographics
NPI:1720415656
Name:SERENITY SPINAL CARE, LLC
Entity Type:Organization
Organization Name:SERENITY SPINAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CECI
Authorized Official - Middle Name:
Authorized Official - Last Name:ARANDA
Authorized Official - Suffix:
Authorized Official - Credentials:CA
Authorized Official - Phone:702-932-6100
Mailing Address - Street 1:9330 W FLAMINGO RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-6429
Mailing Address - Country:US
Mailing Address - Phone:702-932-6100
Mailing Address - Fax:702-932-6102
Practice Address - Street 1:9330 W FLAMINGO RD
Practice Address - Street 2:SUITE 112A
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-6429
Practice Address - Country:US
Practice Address - Phone:702-932-6100
Practice Address - Fax:702-932-6102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-09
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01340111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty