NPIMap

Organization Active NPI

Serenity Residential Homes LLC

  • Substance Abuse Rehabilitation Facility
  • Chandler, AZ
National Provider Identifier
1083282966
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
SERENITY RESIDENTIAL HOMES LLC
Practice address
1001 N Ithica CT
Chandler, AZ 85225-1723
Phone
(480) 200-9183
NPI assigned
Jun 16, 2021
Organization subpart
Yes
Parent organization
SERENITY RESIDENTIAL HOMES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Authorized official

Name
Saida Mohamed
Title
Ceo
Phone
(480) 200-9183

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

1001 N Ithica CT
Chandler, AZ 85225-1723

Mailing address

3722 E Orchid CT
Gilbert, AZ 85296-8268
Phone (480) 200-9183

Other identifiers 1

IdentifierTypeStateIssuer
NONEMedicaidAZ

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL EHR
Other URL EHR

National Provider Directory

National Provider Directory
Tax ID family
Serenity Residential Homes LLC5 organizations share this tax ID, including this one
Part of
Serenity Residential Homes LLC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623801600000",
    "number": "1083282966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3722 E ORCHID CT",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852968268",
            "telephone_number": "480-200-9183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N ITHICA CT",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852251723",
            "telephone_number": "480-200-9183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY RESIDENTIAL HOMES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SERENITY RESIDENTIAL HOMES LLC",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "SAIDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-200-9183"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NONE",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EHR",
            "affiliation": "N",
            "address_1": "1001 N Ithica Ct",
            "city": "Chandler",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852251723",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EHR",
            "affiliation": "N",
            "address_1": "1001 N Ithica Ct",
            "city": "Chandler",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852251723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; 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.