Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health (Including Community Mental Health Center) |
261QM0801X | B4[14] | Community Mental Health Center | |
Family |
363LF0000X | 50 | Nurse Practitioner | |
Nurse Practitioner |
363L00000X | 50 | Nurse Practitioner | |
Psychiatric/Mental Health |
363LP0808X | 50 | Nurse Practitioner |
| NPI Number | 1649042375 |
| LBN Legal business name | CACTUS SERENITY BEHAVIORAL HEALTH SERVICES LLC |
| Authorized official | BEATRICE EKO - (CEO) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 10/25/2023 |
| Last updated | 11/01/2024 - More than a year ago |
| Identifiers | n/a |
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