Serenity Hospice Homes LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

SERENITY HOSPICE HOMES LLC

Practice address

8948 Stratford CT
Brooklyn Park, MN 55443-2976

Phone

(612) 398-6993

NPI assigned

May 24, 2022

Organization subpart

No

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

Authorized official

Name

Carolyne Ellis

Title

Owner/President

Phone

(612) 398-6993

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Hospice certification: CCN 241621

Legal name

SERENITY HOSPICE HOMES LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jan 19, 2024

Last certification

Dec 28, 2023

Organization structure

LLCProprietary

Incorporated

Feb 7, 2022 in MN

Enrollment address

8948 Stratford CT
Brooklyn Park, MN 55443-2976

Listed as

Serenity Hospice Homes LLCCCN 241621

Certified

Jan 19, 2024

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Vannesa Hang Cederstrom, MD

  • Internal Medicine Physician
  • Robbinsdale, MN
  • NPI 1427545557

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1619615218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8948 STRATFORD CT",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554432976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8948 STRATFORD CT",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554432976",
            "telephone_number": "612-398-6993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY HOSPICE HOMES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-24",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "CAROLYNE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "612-398-6993"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Community Based Hospice Care Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.