Serenity Space LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SERENITY SPACE LLC

Practice address

2817 Anthony LN S Ste 203
St Anthony, MN 55418-2491

Phone

(612) 810-6216

NPI assigned

Jul 24, 2023

Organization subpart

No

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

Authorized official

Name

Sacad M GuledNPI 1487070199

Title

Owner

Phone

(612) 810-6216

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Sacad Guled, MBA

  • Home Health Aide
  • Fridley, MN
  • NPI 1487070199
  NPD Authorized official

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

{
    "created_epoch": "1690156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690156800000",
    "number": "1790465664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 ANTHONY LN S STE 203",
            "city": "ST ANTHONY",
            "state": "MN",
            "postal_code": "554182491",
            "telephone_number": "612-810-6216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 ANTHONY LN S STE 203",
            "city": "ST ANTHONY",
            "state": "MN",
            "postal_code": "554182491",
            "telephone_number": "612-810-6216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY SPACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-24",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A",
        "authorized_official_last_name": "GULED",
        "authorized_official_first_name": "SACAD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-810-6216"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faduma Sayid
• Salma Sayid
• Sayidahmed Sayid
• Umalkayr Sayid
• Senzilla Health Services, LLC
• Abdirahmano Ismail Sharmake
• Faiza A Sheikhmohamed
• Abdifatah Sherif
• Ala Sherif
• Maymuna Sherif

• Community/Behavioral Health Agency in St Anthony, MN
• Providers in St Anthony, MN by specialty
• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.