Serenity Haven Group Home LCC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SERENITY HAVEN GROUP HOME LCC

Practice address

2400 Ivy LN
Bloomington, MN 55431-2830

Phone

(763) 567-2015

NPI assigned

Oct 1, 2025

Organization subpart

No

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

Authorized official

Name

Abdiqani Sharif

Title

Owner/Director

Phone

(503) 980-5325

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1759276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759795200000",
    "number": "1609740760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20074 67TH AVE",
            "city": "CORCORAN",
            "state": "MN",
            "postal_code": "553401018",
            "telephone_number": "503-980-5325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 IVY LN",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554312830",
            "telephone_number": "763-567-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY HAVEN GROUP HOME LCC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-01",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A",
        "authorized_official_last_name": "SHARIF",
        "authorized_official_first_name": "ABDIQANI",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "503-980-5325"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Julie Kay Session, NCTMB
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• Michael P Sethna, M.D.
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• Assisted Living Facility in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; 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.