Serenity Senior Living I, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SERENITY SENIOR LIVING I, LLC

Practice address

1025 Cavern Dr
Mesquite, TX 75181-4418

Phone

(972) 629-9707

NPI assigned

Jan 16, 2023

Last updated

Jan 16, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jason L Shaw, LMSW

Title

Manager

Phone

(214) 730-0042

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673827200000",
    "number": "1326753260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3349 INTERSTATE 30",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751502630",
            "telephone_number": "214-730-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 CAVERN DR",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751814418",
            "telephone_number": "972-629-9707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY SENIOR LIVING I, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-16",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "214-730-0042",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Mesquite, TX
• Providers in Mesquite, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; 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.