NPIMap

Organization Active NPI

Serenity Place Alf II

  • Assisted Living Facility
  • Palm Bay, FL
National Provider Identifier
1487080891
Registry record updated Sep 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
11317 Issued in FL
Legal business name
SERENITY PLACE ALF II
Practice address
256 Barbarossa Rd NW
Palm Bay, FL 32907-1809
Phone
(321) 724-6040
NPI assigned
Sep 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2013

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

Authorized official

Name
Nicole Davis
Title
Owner
Phone
(954) 804-9785

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 11317 FL Primary

Addresses

Primary practice location

256 Barbarossa Rd NW
Palm Bay, FL 32907-1809

Mailing address

256 Barbarossa Rd NW
Palm Bay, FL 32907-1809

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379376000000",
    "number": "1487080891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 BARBAROSSA RD NW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329071809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 BARBAROSSA RD NW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329071809",
            "telephone_number": "321-724-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY PLACE ALF II",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-17",
        "last_updated": "2013-09-17",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-804-9785"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "11317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.