Provider Demographics
NPI:1215528690
Name:SERENITY WELLNESS LLC
Entity type:Organization
Organization Name:SERENITY WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KYMBERLI
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYNTON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:951-291-7756
Mailing Address - Street 1:32295 MISSION TRL # R8189
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-2305
Mailing Address - Country:US
Mailing Address - Phone:951-291-7756
Mailing Address - Fax:
Practice Address - Street 1:32295 MISSION TRL # R8189
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-2305
Practice Address - Country:US
Practice Address - Phone:951-291-7756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty