# SERENITY PROVIDER SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962016626
- **Authorized official:** JOSE ANTONIO MARTINEZ (CFO)
- **Authorized official phone:** (956) 452-0202

## Contact information

- **Practice address:** 107 CALLE DEL NORTE \# 17, LAREDO, TX 78041-9104
- **Practice address phone:** (956) 452-0202
- **Mailing address:** 107 CALLE DEL NORTE \# 17107, LAREDO, TX 78041-9104
- **Mailing address phone:** (956) 723-1234
- **Mailing address fax:** (956) 725-5536

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 372500000X | Chore Provider | — | NULL | Yes |
| 372500000X | Chore Provider | — | — | Yes |

## Other

- **Enumeration date:** 09/01/2020
- **Last updated:** 09/08/2020