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Organization
SERENITY WELLNESS LLC
Active
Organization
SERENITY WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN QUIAMBAO MD (CEO)
(405) 790-0500
Entity
Organization
Contact information
Practice address
3750 W MAIN ST STE AA, NORMAN, OK 73072-4645
(405) 790-0500
(405) 790-0501
Mailing address
PO BOX 6708, MOORE, OK 73153-0708
(405) 790-0500
(405) 790-0501
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
24708
OK
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
NULL
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
Other
Enumeration date
01/27/2010
Last updated
09/28/2024
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