Serenity Homes-North

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL700316956 Issued in MI

Legal business name

SERENITY HOMES-NORTH

Practice address

830 Hayes St
Marne, MI 49435-9792

Phone

(616) 677-6015

Fax

(616) 431-5021

NPI assigned

Sep 24, 2013

Organization subpart

Yes

Parent organization

SERENITY HOMES-WEST L.L.C.As reported in NPPES

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

Authorized official

Name

Mr. Abraham, Joshua, M.P.A.

Title

President/Administrator

Phone

(616) 361-6571

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Serenity Homes-North

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

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379980800000",
    "number": "1447686381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 LAWTON DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495252916",
            "telephone_number": "616-361-6571",
            "fax_number": "616-361-0852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 HAYES ST",
            "city": "MARNE",
            "state": "MI",
            "postal_code": "494359792",
            "telephone_number": "616-677-6015",
            "fax_number": "616-431-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY HOMES-NORTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SERENITY HOMES-WEST L.L.C.",
        "enumeration_date": "2013-09-24",
        "last_updated": "2013-09-24",
        "status": "A",
        "authorized_official_last_name": "JOSHUA",
        "authorized_official_first_name": "ABRAHAM,",
        "authorized_official_title_or_position": "PRESIDENT/ADMINISTRATOR",
        "authorized_official_telephone_number": "616-361-6571",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.P.A."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MI",
            "license": "AL700316956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0097737",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sanford Psych Services LLC
• Sanford West LLC
• Sanford West LLC
• Kaitlyn Ilene Seiter, LLMSW
• Nicholas James Selzer
• Serenity Homes-North
• Serenity Point Recovery Inc
• Shining Shield Medical Group, PC
• Bibhas Singla, M.D.
• Sophia Noel Smith, MS RDN

• Assisted Living Facility in Marne, MI
• Providers in Marne, MI by specialty
• Assisted Living Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; 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.