Serenity Home of Maricopa .LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

BH4439 Issued in AZ

Legal business name

SERENITY HOME OF MARICOPA .LLC

Practice address

43350 W Elizabeth Ave
Maricopa, AZ 85138-5716

Phone

(520) 431-7587

NPI assigned

Jul 16, 2014

Last updated

Jul 16, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Vivian Wright

Title

Executive Director

Phone

(520) 431-7587

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405468800000",
    "number": "1831506328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41282 W CAPISTRANO DR",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851384591",
            "telephone_number": "520-431-7587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43350 W ELIZABETH AVE",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851385716",
            "telephone_number": "520-431-7587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY HOME OF MARICOPA .LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-16",
        "last_updated": "2014-07-16",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "520-431-7587",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "AZ",
            "license": "BH4439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isaac Scott, DPT
• Patricia Lowe Sepulveda, M D
• Serene Home Healthcare LLC
• Serene Mercy Nursing LLC
• Serenity Care Consultants
• Ehfad M Shah, DMD
• Shared Spaces LLC
• Hessam Sharifi
• Mason Shaw, PT, DPT
• Theresa Shibilski

• Emotionally Disturbed Childrens' Residential Treatment Facility in Maricopa, AZ
• Providers in Maricopa, AZ by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; 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.