Serenity Living Center

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

372061 Issued in MN

Legal business name

SERENITY LIVING CENTER

Doing business as

Serenity Assisted Living

Practice address

1125 Oakview Dr
Dilworth, MN 56529-1827

Phone

(218) 477-7254

Fax

(218) 477-7255

NPI assigned

Nov 6, 2015

Last updated

Nov 6, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Richard Anderson

Title

Manager

Phone

(218) 477-7254

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Serenity Assisted Living Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1446768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446768000000",
    "number": "1003289406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 OAKVIEW DR",
            "city": "DILWORTH",
            "state": "MN",
            "postal_code": "565291827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 OAKVIEW DR",
            "city": "DILWORTH",
            "state": "MN",
            "postal_code": "565291827",
            "telephone_number": "218-477-7254",
            "fax_number": "218-477-7255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY LIVING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-06",
        "last_updated": "2015-11-06",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "218-477-7254",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "372061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMPI",
            "identifier": "M183447400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMPI",
            "identifier": "M559433000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serenity Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Dilworth, MN
• Providers in Dilworth, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.