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Organization

ARC SERENITY SERVICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEBEH BAIMBA CRNP (OWNER)
(832) 677-7015
Entity
Organization

Contact information

Practice address
13521 MONTFORT DR, DALLAS, TX 75240-5120
(214) 302-7171
(657) 213-2652
Mailing address
13521 MONTFORT DR, DALLAS, TX 75240-5120
(214) 302-7171
(657) 213-2652

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
363LF0000X
Family Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1075618
LICENSE
TX
Enumeration date
09/05/2022
Last updated
09/05/2022
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