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Organization
SERENITY PLACE FAMILY THERAPY LLC
Active
Organization
SERENITY PLACE FAMILY THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID DALE (ADMINISTRATOR)
(281) 419-9669
Entity
Organization
Contact information
Practice address
2219 SAWDUST RD STE 1101, THE WOODLANDS, TX 77380-2580
(832) 264-1928
Mailing address
2219 SAWDUST RD STE 1101, THE WOODLANDS, TX 77380-2580
(832) 264-1928
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0040FV
BCBSTX
TX
05
—
397962701
—
TX
01
—
799586
PTAN
—
Enumeration date
02/01/2019
Last updated
08/02/2022
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