NPIMap

Organization Active NPI

Serenity Residential Homes, LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Gilbert, AZ
National Provider Identifier
1508488495
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
SERENITY RESIDENTIAL HOMES, LLC
Practice address
3722 E Orchid CT
Gilbert, AZ 85296-8268
Phone
(480) 200-9183
Fax
(480) 207-5977
NPI assigned
May 13, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Authorized official

Name
Saida Mohamed
Title
Owner
Phone
(480) 200-9183

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

3722 E Orchid CT
Gilbert, AZ 85296-8268

Mailing address

3100 W Ray Rd Ste 201
Chandler, AZ 85226-2472
Phone (480) 200-9183

Other identifiers 1

IdentifierTypeStateIssuer
BH5593OtherAZBEHAVIORAL HEALTH RESIDENTIAL FACILITY

National Provider Directory

National Provider Directory
Tax ID family
Serenity Residential Homes LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1589328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589414400000",
    "number": "1508488495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 W RAY RD STE 201",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852262472",
            "telephone_number": "480-200-9183",
            "fax_number": "480-207-5977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3722 E ORCHID CT",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852968268",
            "telephone_number": "480-200-9183",
            "fax_number": "480-207-5977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY RESIDENTIAL HOMES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-13",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "SAIDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-200-9183"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIORAL HEALTH RESIDENTIAL FACILITY",
            "identifier": "BH5593",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; 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.