Provider Demographics
NPI:1154955391
Name:SERENITY PEAKS, LLC
Entity type:Organization
Organization Name:SERENITY PEAKS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LPC
Authorized Official - Prefix:
Authorized Official - First Name:HOLLIE
Authorized Official - Middle Name:DEANN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:970-623-1857
Mailing Address - Street 1:3024 BIG BIRD AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81504-4100
Mailing Address - Country:US
Mailing Address - Phone:970-623-1857
Mailing Address - Fax:
Practice Address - Street 1:390 SORREL ST
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-7850
Practice Address - Country:US
Practice Address - Phone:970-623-1857
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty