Serene Residential Care Home LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SERENE RESIDENTIAL CARE HOME LLC

Practice address

1848 Chatfield Cir
Stockton, CA 95209-4239

Phone

(209) 283-8728

NPI assigned

Feb 17, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Chukwudi Ikiseh

Title

Administrator for Assisted Living

Phone

(209) 283-8728

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1676592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676592000000",
    "number": "1508564642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1848 CHATFIELD CIR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952094239",
            "telephone_number": "510-860-5725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1848 CHATFIELD CIR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952094239",
            "telephone_number": "209-283-8728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENE RESIDENTIAL CARE HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-17",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A",
        "authorized_official_last_name": "IKISEH",
        "authorized_official_first_name": "CHUKWUDI",
        "authorized_official_title_or_position": "ADMINISTRATOR FOR ASSISTED LIVING",
        "authorized_official_telephone_number": "209-283-8728",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Stockton, CA
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• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; 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.