Serenity Care Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SERENITY CARE HOME

Practice address

13552 Utt Dr
Tustin, CA 92780-4547

Phone

(714) 617-5883

NPI assigned

Dec 11, 2020

Last updated

Dec 11, 2020By 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

Miriam Salcedo

Title

Administrator

Phone

(949) 346-6010

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607644800000",
    "number": "1881290013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13552 UTT DR",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927804547",
            "telephone_number": "714-617-5883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13552 UTT DR",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927804547",
            "telephone_number": "714-617-5883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-11",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A",
        "authorized_official_last_name": "SALCEDO",
        "authorized_official_first_name": "MIRIAM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "949-346-6010"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "NA",
            "affiliation": "N",
            "endpointDescription": "NA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "NA",
            "address_1": "13552 Utt Dr",
            "city": "Tustin",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927804547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.