NPIMap

Organization Active NPI

Serenity Care Solutions LLC

  • Community Based Hospice Care Agency
  • Highlands, TX
National Provider Identifier
1457967176
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
SERENITY CARE SOLUTIONS LLC
Practice address
607 E Wallisville Rd
Highlands, TX 77562-3831
Phone
(732) 484-6354
NPI assigned
Sep 17, 2020
Last updated
Sep 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Authorized official

Name
Miss Mary Youssif, MBA
Title
Ceo / Founder
Phone
(732) 484-6354

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X NU Primary

Addresses

Primary practice location

607 E Wallisville Rd
Highlands, TX 77562-3831

Mailing address

607 E Wallisville Rd
Highlands, TX 77562-3831
Phone (732) 484-6354

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210308000120 TX Part A Provider - Hospice 5799191334 Practice locations: Highlands, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1457967176. Details of each certification follow.

Hospice certification: CCN 971684

Legal name
SERENITY CARE SOLUTIONS LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Sep 9, 2021
Last certification
Sep 9, 2021
Ownership / control type
Proprietary - Partnership
Organization structure
LLCProprietary
Incorporated
Sep 1, 2020 in TX
Enrollment address
607 E Wallisville Rd
Highlands, TX 77562-3831

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Serenity Care Solutions, LLCCCN 971684 · All quality measures
Ownership
For-Profit
Certified
Sep 9, 2021
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Serenity Care Solutions LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Dallal Abdelsayed Individual 5% Or Greater Direct Ownership InterestOwner, Administrator Sep 1, 2020 50%
General Partnership InterestOwner, Administrator Sep 1, 2020 50%
Mary Youssif Individual 5% Or Greater Direct Ownership InterestOwner, Ceo and Alt Administrator Sep 1, 2020 50%
General Partnership InterestOwner ,Ceo and Alt Administrator Sep 1, 2020 50%
Operational/Managerial ControlCeo and Alt Administrator Sep 1, 2020 5%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

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.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600300800000",
    "number": "1457967176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 E WALLISVILLE RD",
            "city": "HIGHLANDS",
            "state": "TX",
            "postal_code": "775623831",
            "telephone_number": "732-484-6354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 E WALLISVILLE RD",
            "city": "HIGHLANDS",
            "state": "TX",
            "postal_code": "775623831",
            "telephone_number": "732-484-6354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY CARE SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-17",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A",
        "authorized_official_last_name": "YOUSSIF",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "CEO / FOUNDER",
        "authorized_official_telephone_number": "732-484-6354",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highlands, TX

Sources for this page

Verify at the official NPI Registry.