NPIMap

Organization Active NPI

Serenity Wellness, LLC

  • Community/Behavioral Health Agency
  • Caldwell, ID
National Provider Identifier
1497397723
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SERENITY WELLNESS, LLC
Practice address
524 Cleveland Blvd Ste 230
Caldwell, ID 83605-4076
Phone
(208) 800-0588
Fax
(208) 800-0599
NPI assigned
Oct 8, 2019
Last updated
Oct 8, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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

Authorized official

Name
Aaron Elias St.George, B.S., ICADCNPI 1255813044
Title
Executive Director
Phone
(208) 800-0588

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Adult Mental Health Clinic/Center 261QM0850X NU
Substance Abuse Rehabilitation Facility 324500000X NU
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

524 Cleveland Blvd Ste 230
Caldwell, ID 83605-4076

Mailing address

524 Cleveland Blvd Ste 230
Caldwell, ID 83605-4076
Phone (208) 800-0588

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570492800000",
    "number": "1497397723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 CLEVELAND BLVD STE 230",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054076",
            "telephone_number": "208-800-0588",
            "fax_number": "208-800-0599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 CLEVELAND BLVD STE 230",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054076",
            "telephone_number": "208-800-0588",
            "fax_number": "208-800-0599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-08",
        "last_updated": "2019-10-08",
        "status": "A",
        "authorized_official_last_name": "ST.GEORGE",
        "authorized_official_first_name": "AARON",
        "authorized_official_middle_name": "ELIAS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "208-800-0588",
        "authorized_official_credential": "B.S., ICADC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; 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.