NPIMap

Organization Active NPI

Serenity Home Care LLC

  • In Home Supportive Care Agency
  • Beaverton, OR
National Provider Identifier
1205280286
Registry record updated Apr 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
15-2301 Issued in OR
Legal business name
SERENITY HOME CARE LLC
Practice address
12725 SW Millikan Way Ste 300
Beaverton, OR 97005-1687
Phone
(503) 520-9400
Fax
(503) 520-9401
NPI assigned
Apr 15, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2016

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

Authorized official

Name
Sheda P. Dikeman
Title
Administrator
Phone
(503) 740-2212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 15-2301 OR Primary

Addresses

Primary practice location

12725 SW Millikan Way Ste 300
Beaverton, OR 97005-1687

Mailing address

12725 SW Millikan Way Ste 300
Beaverton, OR 97005-1687
Phone (503) 520-9400

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1460678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460678400000",
    "number": "1205280286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12725 SW MILLIKAN WAY STE 300",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970051687",
            "telephone_number": "503-520-9400",
            "fax_number": "503-520-9401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12725 SW MILLIKAN WAY STE 300",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970051687",
            "telephone_number": "503-520-9400",
            "fax_number": "503-520-9401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-15",
        "last_updated": "2016-04-15",
        "status": "A",
        "authorized_official_last_name": "DIKEMAN",
        "authorized_official_first_name": "SHEDA",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "503-740-2212"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "OR",
            "license": "15-2301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2016; 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.