| Serenity Space Llc | |
|
2817 Anthony Ln S Ste 203 St Anthony MN 55418-2491 | |
| (612) 810-6216 | |
| Not Available |
| Full Name | Serenity Space Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2817 Anthony Ln S Ste 203, St Anthony, Minnesota |
| Authorized Official Name and Position | Sacad M Guled (OWNER) |
| Authorized Official Contact | 6128106216 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Serenity Space Llc 2817 Anthony Ln S Ste 203 St Anthony MN 55418-2491 Ph: (612) 810-6216 | Serenity Space Llc 2817 Anthony Ln S Ste 203 St Anthony MN 55418-2491 Ph: (612) 810-6216 |
| NPI Number | 1790465664 |
|---|---|
| Provider Enumeration Date | 07/24/2023 |
| Last Update Date | 07/24/2023 |
| Certification Date | 07/24/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790465664 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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