Serenity Senior Care LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL12595 Issued in FL

Legal business name

SERENITY SENIOR CARE LLC

Practice address

2680 SE Brevard Ave
Port St Lucie, FL 34952-7203

Phone

(772) 204-2215

Fax

(772) 905-8048

NPI assigned

Jan 15, 2015

Organization subpart

No

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

Authorized official

Name

Denise Ricketts

Title

Adminisstrator

Phone

(786) 390-2290

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1421280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421280000000",
    "number": "1790174589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2680 SE BREVARD AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 SE BREVARD AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527203",
            "telephone_number": "772-204-2215",
            "fax_number": "772-905-8048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY SENIOR CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-15",
        "last_updated": "2015-01-15",
        "status": "A",
        "authorized_official_last_name": "RICKETTS",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "ADMINISSTRATOR",
        "authorized_official_telephone_number": "786-390-2290"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.