Organization Active NPI

Serenity Blue LLC

  • Voluntary or Charitable Agency
  • Harrisburg, PA
National Provider Identifier
1174131783
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Voluntary or Charitable AgencyTaxonomy code 251V00000X
Legal business name
SERENITY BLUE LLC
Practice address
2405 Linglestown Rd Ste 1
Harrisburg, PA 17110-9429
Phone
(858) 245-8327
NPI assigned
Jul 20, 2020
Last updated
Mar 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Authorized official

Name
E M
Title
Executive Director
Phone
(717) 914-4105

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Voluntary or Charitable Agency 251V00000X Primary

Addresses

Primary practice location

2405 Linglestown Rd Ste 1
Harrisburg, PA 17110-9429

Mailing address

2232 Chatham Way
Harrisburg, PA 17110-3959
Phone (858) 245-8327

Other names 1

  • Serenity Blue Dialysis Care Other name

National Provider Directory

National Provider Directory

Locations

2405 Linglestown Rd
Ste 1
Harrisburg, PA 17110
Phone (717) 914-4105

NPI Registry JSON

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741910400000",
    "number": "1174131783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2232 CHATHAM WAY",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171103959",
            "telephone_number": "858-245-8327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 LINGLESTOWN RD STE 1",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171109429",
            "telephone_number": "858-245-8327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY BLUE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-20",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A",
        "authorized_official_last_name": "M",
        "authorized_official_first_name": "E",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "717-914-4105"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serenity Blue Dialysis Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; 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.