NPIMap

Organization Active NPI

Serenity Outpatient Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • El Paso, TX
National Provider Identifier
1184669145
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
564-A Issued in TX
Legal business name
SERENITY OUTPATIENT SERVICES, INC.
Practice address
4625 Alabama St,
Suite C
El Paso, TX 79930
Phone
(915) 566-2000
Fax
(915) 566-2056
NPI assigned
Jun 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. David J Kruzich, PH.DNPI 1073510111
Title
Ceo, Owner
Phone
(915) 566-2000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 564-A TX Primary

Addresses

Primary practice location

4625 Alabama St,
Suite C
El Paso, TX 79930

Mailing address

4625 Alabama St, Ste C
El Paso, TX 79930
Phone (915) 566-2000

Other names 1

  • SOS, Inc. Other name

National Provider Directory

National Provider Directory

Locations

4625 Alabama St
Ste C
El Paso, TX 79930
Phone (915) 566-2000

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184669145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4625 ALABAMA ST, STE C",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79930",
            "telephone_number": "915-566-2000",
            "fax_number": "915-566-2056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4625 ALABAMA ST,",
            "address_2": "SUITE C",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79930",
            "telephone_number": "915-566-2000",
            "fax_number": "915-566-2056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY OUTPATIENT SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KRUZICH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO, OWNER",
        "authorized_official_telephone_number": "915-566-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "TX",
            "license": "564-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOS, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.