Serenity Health Services LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

SERENITY HEALTH SERVICES LLC

Practice address

6530 University Ave NE Apt 412
Fridley, MN 55432-3311

Phone

(763) 332-8630

NPI assigned

Sep 18, 2024

Organization subpart

No

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

Authorized official

Name

Suheb Awil Ibrahim

Title

Owner

Phone

(763) 332-8630

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1447087879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6530 UNIVERSITY AVE NE APT 412",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554323311",
            "telephone_number": "763-332-8630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6530 UNIVERSITY AVE NE APT 412",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554323311",
            "telephone_number": "763-332-8630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "SUHEB",
        "authorized_official_middle_name": "AWIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-332-8630"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Sears
• Corinne Segal, LPCC
• Nickolas Sell, PHARMD
• Kathryn Kim Selmo, MD
• Betlehem Semahge, M.D.
• Austin C Seward, DDS
• Shaisma Care LLC
• Jessica Shappell
• Saharo Sharif-Isaack X
• Abdullahi Sharif

• Clinic/Center in Fridley, MN
• Providers in Fridley, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.