Serenity Manor Inc

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

6261 Issued in OH

Legal business name

SERENITY MANOR INC

Doing business as

Serenity Manor

Practice address

87 Staley Rd
Orwell, OH 44076-8377

Phone

(440) 437-7171

Fax

(440) 437-1086

NPI assigned

May 26, 2006

Last updated

Aug 22, 2020By 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

Mrs. Beatrice A Knowlson, RN/LNHA

Title

Owner

Phone

(440) 992-8387

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Serenity Manor Doing business as

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376590406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 W PROSPECT RD",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440046439",
            "telephone_number": "440-992-8387",
            "fax_number": "440-992-7650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 STALEY RD",
            "city": "ORWELL",
            "state": "OH",
            "postal_code": "440768377",
            "telephone_number": "440-437-7171",
            "fax_number": "440-437-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY MANOR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KNOWLSON",
        "authorized_official_first_name": "BEATRICE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-992-8387",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN/LNHA"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "OH",
            "license": "6261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2357579",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serenity Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nursing Facility/Intermediate Care Facility in Orwell, OH
• Providers in Orwell, OH by specialty
• Nursing Facility/Intermediate Care Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.