Organization Active NPI

Serenity Lane Behavioral Healthcare LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Anchorage, AK
National Provider Identifier
1376416305
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SERENITY LANE BEHAVIORAL HEALTHCARE LLC
Practice address
205 E Benson Blvd Ste 442
Anchorage, AK 99503-4019
Phone
(907) 244-1074
Fax
(930) 234-3013
NPI assigned
Sep 25, 2025
Last updated
Nov 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Authorized official

Name
Onome T OkurumeNPI 1326480609
Title
Owner
Phone
(907) 244-1074

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

205 E Benson Blvd Ste 442
Anchorage, AK 99503-4019

Mailing address

205 E Dimond Blvd
PMB 582
Anchorage, AK 99515-1909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251104001240 AK Part B Supplier - Clinic/Group Practice 1456841956 Receives reassigned benefits from 1 practitioner
Practice locations: Anchorage, AK

National Provider Directory

National Provider Directory

Locations

205 E Benson Blvd
Ste 442
Anchorage, AK 99503
Phone (907) 244-1074

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1758758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762300800000",
    "number": "1376416305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E DIMOND BLVD",
            "address_2": "PMB 582",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995151909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E BENSON BLVD STE 442",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995034019",
            "telephone_number": "907-244-1074",
            "fax_number": "930-234-3013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY LANE BEHAVIORAL HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-25",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A",
        "authorized_official_last_name": "OKURUME",
        "authorized_official_first_name": "ONOME",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-244-1074"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.