Serenity Care Villa, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SERENITY CARE VILLA, INC

Doing business as

Serenity Care Villa
Serenity Care Villa, LLC

Practice address

7274 Pritchard Rd
Sacramento, CA 95828-3620

Phone

(916) 598-8989

NPI assigned

Sep 10, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Ibifubara T Jack

Title

Administrator

Phone

(916) 598-8989

Specialties & licenses 1

Addresses

Other names 2

• Serenity Care Villa Doing business as
• Serenity Care Villa, LLC Doing business as

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725926400000",
    "number": "1427884113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7274 PRITCHARD RD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958283620",
            "telephone_number": "916-598-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7274 PRITCHARD RD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958283620",
            "telephone_number": "916-598-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY CARE VILLA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-10",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A",
        "authorized_official_last_name": "JACK",
        "authorized_official_first_name": "IBIFUBARA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "916-598-8989",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serenity Care Villa",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Serenity Care Villa, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Scott Louie Serbas
• Christian L. Serdahl, M.D.
• Sannaporn Sereevinyayut, MD
• Serene Health
• Serenity Bean Family and Marriage Therapy, Professional Organization
• Serenity Dental Office
• Serenity Wellness Nursing Practice Inc
• Roya Sereshki, PHARMD
• Monique Sergeeff
• Sergey Mahtesyan DDS, Inc

• Assisted Living Facility in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.