Serenity Therapy Center LLC

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

SERENITY THERAPY CENTER LLC

Practice address

1129 Maple St
Eagan, MN 55121-4402

Phone

(763) 732-2594

NPI assigned

Jan 30, 2025

Organization subpart

No

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

Authorized official

Name

Kafia A Jama

Title

Managing Owner

Phone

(763) 732-2594

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1738195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738195200000",
    "number": "1255144317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 MAPLE ST",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551214402",
            "telephone_number": "763-732-2594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 MAPLE ST",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551214402",
            "telephone_number": "763-732-2594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY THERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-30",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A",
        "authorized_official_last_name": "JAMA",
        "authorized_official_first_name": "KAFIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING OWNER",
        "authorized_official_telephone_number": "763-732-2594"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary L Sedivy, D.D.S.
• Sempron Medical Supplier LLC
• Seo, LLC
• Serenity Behavioral Health LLC
• Serenity Support Services LLC
• Jennifer Buenaflor Servidad
• Rashidah Shabazz
• Angela Marie Shade, PHARM.D
• Joseph Jacob Shaffer, M.D.
• Kristina Kelly Shaffer, M.D.

• Early Intervention Provider Agency in Eagan, MN
• Providers in Eagan, MN by specialty
• Early Intervention Provider Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.