Organization
SERENITYMIND CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FUNSHO KING (OWNER OF ENTITY)
(651) 237-3319
Entity
Organization
Contact information
Practice address
6818 91ST ST S, COTTAGE GROVE, MN 55016-4184
(651) 237-3319
Mailing address
6818 91ST ST S, COTTAGE GROVE, MN 55016-4184
(651) 237-3319
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/11/2025
Last updated
07/11/2025
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