Hayeshua Serenity Care PLLC

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

Legal business name

HAYESHUA SERENITY CARE PLLC

Practice address

316 W Pinnacle Ridge Dr
San Tan Valley, AZ 85140-7047

Phone

(860) 967-2388

NPI assigned

Aug 24, 2023

Last updated

Aug 24, 2023By 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

Matilda BoachieNPI 1306571468

Title

Owner

Phone

(860) 967-2388

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matilda Boachie, PMHNP

  • Psychiatry Physician
  • San Tan Valley, AZ
  • NPI 1306571468
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692835200000",
    "number": "1023892429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 W PINNACLE RIDGE DR",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851407047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 W PINNACLE RIDGE DR",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851407047",
            "telephone_number": "860-967-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAYESHUA SERENITY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A",
        "authorized_official_last_name": "BOACHIE",
        "authorized_official_first_name": "MATILDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-967-2388"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Troy Hardman, PT
• Hailey Reagan Hardy
• Joshua Harrel, RN
• Angela Harvey, WHNP
• Latice Hayes
• Healing Arms of Love Behavioral LLC
• Healing Beginnings LLC
• Healing Touch Behavior Health LLC
• Heavenly Caregivers LLC
• Kelly S Heitic

• Psychiatric/Mental Health Registered Nurse in San Tan Valley, AZ
• Providers in San Tan Valley, AZ by specialty
• Psychiatric/Mental Health Registered Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.