Serene Grace Assisted Living Home LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

101199 Issued in AK

Legal business name

SERENE GRACE ASSISTED LIVING HOME LLC

Practice address

3639 E 74TH Ave
Anchorage, AK 99507-2829

Phone

(907) 272-4073

Fax

(907) 522-1626

NPI assigned

Oct 18, 2017

Organization subpart

No

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

Authorized official

Name

Ms. Mirasol Williams

Title

Sole Member

Phone

(907) 272-4073

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1508284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1285145193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3639 E 74TH AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995072829",
            "telephone_number": "907-272-4073",
            "fax_number": "907-522-1626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3639 E 74TH AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995072829",
            "telephone_number": "907-272-4073",
            "fax_number": "907-522-1626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7810 Alpine View Cir",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995075704",
            "country_code": "US",
            "telephone_number": "907-375-0422",
            "fax_number": "907-375-0432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SERENE GRACE ASSISTED LIVING HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-18",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MIRASOL",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "907-272-4073",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AK",
            "license": "101199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ALASKA",
            "identifier": "101199",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ALASKA",
            "identifier": "1051694",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyungrim Seo
• Sejin Seo
• Hilaria Sepulveda Benavides
• Brandon Serafin
• Serene Grace Assisted Living Home
• Serenity Care Alh, LLC
• Serenity Counseling, LLC
• Serenity Lane Behavioral Healthcare LLC
• Serenity Suites Too, Inc
• Serenity Suites, Corp

• Assisted Living Facility in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Assisted Living Facility in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.