Serenity Gardens of Bradenton, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL11603 Issued in FL

Legal business name

SERENITY GARDENS OF BRADENTON, LLC

Practice address

2211 29TH Ave W
Bradenton, FL 34205-5254

Phone

(941) 746-7711

Fax

(941) 746-7712

NPI assigned

Aug 12, 2011

Last updated

Aug 12, 2011By 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

Ms. Roberta Ellen Jackson, LPN, CD

Title

President/Administrator

Phone

(941) 746-7711

Specialties & licenses 1

Addresses

Other names 1

• Serenity Gardens of Bradenton Other name

Locations

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

{
    "created_epoch": "1313107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313107200000",
    "number": "1417236001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 29TH AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342055254",
            "telephone_number": "941-746-7711",
            "fax_number": "941-746-7712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 29TH AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342055254",
            "telephone_number": "941-746-7711",
            "fax_number": "941-746-7712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY GARDENS OF BRADENTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-12",
        "last_updated": "2011-08-12",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ROBERTA",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "PRESIDENT/ADMINISTRATOR",
        "authorized_official_telephone_number": "941-746-7711",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPN, CD"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL11603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serenity Gardens of Bradenton",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Khydine Senior, APRN
• Gary Edward Senteney, M.D.
• Rosan Marie Sequeda, M.D.
• Serene Bebe LLC
• Serenity Counseling LCSW LLC
• Serenity Springs Clinical Counseling LLC (Serenity Springs Clinical Counseling)
• Rebecca Lee Serijan, A.P.
• Daniel J. Serpentelli III, DC
• Alexandra Riley Servia, MA, LMHC, NCC
• Service Industry Solutions Inc.

• Assisted Living Facility in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2011; 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.