Organization Active NPI

Serenethos Care Center, LLC

  • Skilled Nursing Facility
  • Hayward, CA
National Provider Identifier
1770084121
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SERENETHOS CARE CENTER, LLC
Practice address
22822 Myrtle St
Hayward, CA 94541-6321
Phone
(510) 537-4844
NPI assigned
Feb 21, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2022

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

Authorized official

Name
Ms. Qing Xie
Title
Ceo
Phone
(510) 733-3877

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X CA Primary
Skilled Nursing Facility 314000000X

Addresses

Primary practice location

22822 Myrtle St
Hayward, CA 94541-6321

Mailing address

553 Smalley Ave
Hayward, CA 94541-4919

Other identifiers 2

IdentifierTypeStateIssuer
1760471346OtherNPI
05A347MedicaidCA

Other names 1

  • st. Christopher convalescent hospital,inc Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180326001512 CA Part A Provider - Skilled Nursing Facility 8921360272 Practice locations: Hayward, CA

Skilled nursing facility certification: CCN 555905

Legal name
SERENETHOS CARE CENTER, LLC
Doing business as
LTC CONSULTING
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 16, 2017
Last certification
May 10, 2024
Beds
36
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Feb 10, 2018 in CA
Enrollment address
22822 Myrtle St
Hayward, CA 94541-6321
Nursing home name
SERENETHOS CARE CENTER, LLC

Care Compare: Nursing home

Medicare Care Compare
Listed as
Serenethos Care Center, LLCCCN 555905 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
May 16, 2017
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
3631.9 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0599009Serenethos Care and Rehab Center, LLC22822 Myrtle St, Hayward, CA 94541Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Hansen Hunter LLC Organization, Portland, OR Consulting firm Adp of the SNF Aug 1, 2019
Andrew CHI-Wei NG Individual Operational/Managerial Control Mar 1, 2018
Managing Control - Governing Body Mar 1, 2018
Adp of the SNF Mar 1, 2018
Dickman Weston Group Organization, Rocklin, CA Consulting firm Adp of the SNF Aug 1, 2019
Qing Xie Individual 5% Or Greater Direct Ownership InterestCeo Mar 1, 2018 80%
Adp of the SNF Mar 1, 2018
Direct Ownership Interest Mar 1, 2018 80%
Serenethos Care Center, LLC Organization, Hayward, CA Created for acquisition, LLC 5% Or Greater Direct Ownership Interest Mar 1, 2018 100%
Operational/Managerial Control Mar 1, 2018 100%
Adp of the SNF Apr 1, 2025
Ronald E Baldwin Individual 5% Or Greater Direct Ownership Interest Mar 1, 2018 20%
Operational/Managerial Control Mar 1, 2018
Adp of the SNF Mar 1, 2018
Direct Ownership Interest Mar 1, 2018 20%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

NPI Registry JSON

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645056000000",
    "number": "1770084121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "553 SMALLEY AVE",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945414919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22822 MYRTLE ST",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945416321",
            "telephone_number": "510-537-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENETHOS CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-21",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A",
        "authorized_official_last_name": "XIE",
        "authorized_official_first_name": "QING",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "510-733-3877",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1760471346",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05A347",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "st. Christopher convalescent hospital,inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Hayward, CA

Sources for this page

Verify at the official NPI Registry.