Serenity Support Services LLC

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

SERENITY SUPPORT SERVICES LLC

Practice address

4651 Nicols Rd Ste 205
Eagan, MN 55122-3424

Phone

(651) 239-8745

NPI assigned

Oct 9, 2024

Organization subpart

No

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

Authorized official

Name

Aeysha Nur

Title

Owner

Phone

(651) 239-8745

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769644800000",
    "number": "1033938675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 NICOLS RD STE 205",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551223424",
            "telephone_number": "651-239-8745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4651 NICOLS RD STE 205",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551223424",
            "telephone_number": "651-239-8745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY SUPPORT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-09",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A",
        "authorized_official_last_name": "NUR",
        "authorized_official_first_name": "AEYSHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-239-8745"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Seaborg, MSW, LICSW
• Mary L Sedivy, D.D.S.
• Sempron Medical Supplier LLC
• Seo, LLC
• Serenity Behavioral Health LLC
• Serenity Therapy Center LLC
• Jennifer Buenaflor Servidad
• Rashidah Shabazz
• Angela Marie Shade, PHARM.D
• Joseph Jacob Shaffer, M.D.

• Assisted Living Facility (Mental Illness) in Eagan, MN
• Providers in Eagan, MN by specialty
• Assisted Living Facility (Mental Illness) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; 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.