NPIMap

Organization Active NPI

Serenity Preferred LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Buckeye, AZ
National Provider Identifier
1336865948
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
SERENITY PREFERRED LLC
Practice address
23004 W Hopi St
Buckeye, AZ 85326-8615
Phone
(623) 523-2297
NPI assigned
Oct 14, 2022
Last updated
Oct 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Authorized official

Name
Adebola A Adaralegbe
Title
Program Director
Phone
(623) 523-2297

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X NU Primary

Addresses

Primary practice location

23004 W Hopi St
Buckeye, AZ 85326-8615

Mailing address

23004 W Hopi St
Buckeye, AZ 85326-8615
Phone (623) 523-2297

Other identifiers 1

IdentifierTypeStateIssuer
BH7928OtherAZAZDHS

Other names 1

  • SERENITY PREFERRED LLC Other name

National Provider Directory

National Provider Directory
Tax ID family
Serenity Preferred LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1665705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665705600000",
    "number": "1336865948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23004 W HOPI ST",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853268615",
            "telephone_number": "623-523-2297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23004 W HOPI ST",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853268615",
            "telephone_number": "623-523-2297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY PREFERRED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-14",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A",
        "authorized_official_last_name": "ADARALEGBE",
        "authorized_official_first_name": "ADEBOLA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "623-523-2297"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZDHS",
            "identifier": "BH7928",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SERENITY PREFERRED LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Buckeye, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; 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.