Organization
SERENITY INTEGRATED PRACTICE SIP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARSICIO GACHERU CNP (CEO)
(146) 531-6583
Entity
Organization
Contact information
Practice address
700 BRYDEN RD # 122, COLUMBUS, OH 43215-4839
(146) 787-5183
Mailing address
5719 LAURA LN, HILLIARD, OH 43026-7339
(614) 961-7639
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
01/12/2023
Last updated
09/05/2024
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