NPIMap

Organization Active NPI

Serenity for Life

  • Community/Behavioral Health Agency
  • Long Beach, CA
National Provider Identifier
1710361969
Registry record updated Jul 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
190821AP Issued in CA
Legal business name
SERENITY FOR LIFE
Practice address
65 Pine Ave
360
Long Beach, CA 90802
Phone
(626) 755-0003
NPI assigned
Jul 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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

Authorized official

Name
Benjamin F CoreyNPI 1144518754
Title
Duel Owner
Phone
(626) 755-0003

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 190821AP CA Primary

Addresses

Primary practice location

65 Pine Ave
360
Long Beach, CA 90802

Mailing address

65 Pine Ave
360
Long Beach, CA 90802-4718

National Provider Directory

National Provider Directory
Tax ID family
Benjamin Corey2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

65 Pine Ave
Long Beach, CA 90802
Phone (626) 755-0003

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437091200000",
    "number": "1710361969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 PINE AVE",
            "address_2": "360",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 PINE AVE",
            "address_2": "360",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90802",
            "telephone_number": "626-755-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY FOR LIFE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-17",
        "last_updated": "2015-07-17",
        "status": "A",
        "authorized_official_last_name": "COREY",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "DUEL OWNER",
        "authorized_official_telephone_number": "626-755-0003"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "190821AP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.