NPIMap

Organization Active NPI

Serenity Square LLC

  • Developmentally Disabled Services Day Training Agency
  • Lafayette, LA
National Provider Identifier
1225470230
Registry record updated Jul 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
15006-B Issued in LA
Legal business name
SERENITY SQUARE LLC
Doing business as
Ageless Independence Center
Practice address
1011 Surrey St
Lafayette, LA 70501-6142
Phone
(337) 456-4873
Fax
(337) 266-5893
NPI assigned
Jul 19, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2013

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

Authorized official

Name
Gwendolyn Caillier
Title
Administrator
Phone
(337) 654-5519

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 15006-B LA Primary

Addresses

Primary practice location

1011 Surrey St
Lafayette, LA 70501-6142

Mailing address

500 Surrey St
Lafayette, LA 70501-6134
Phone (337) 266-5892

Other names 1

  • Ageless Independence Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ageless Healthcare7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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": "1374192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374192000000",
    "number": "1225470230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SURREY ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705016134",
            "telephone_number": "337-266-5892",
            "fax_number": "337-266-5893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 SURREY ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705016142",
            "telephone_number": "337-456-4873",
            "fax_number": "337-266-5893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY SQUARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-19",
        "last_updated": "2013-07-19",
        "status": "A",
        "authorized_official_last_name": "CAILLIER",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "337-654-5519"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "LA",
            "license": "15006-B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ageless Independence Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2013; 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.