NPIMap

Organization Active NPI

Serenity Care Health Group

  • Federally Qualified Health Center (FQHC)
  • Long Beach, CA
National Provider Identifier
1902663305
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SERENITY CARE HEALTH GROUP
Practice address
780 Atlantic Ave
Long Beach, CA 90813-4565
Phone
(562) 573-3602
NPI assigned
Mar 1, 2024
Last updated
Sep 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
Arlene Medina
Title
Executive Director
Phone
(562) 478-4107

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

780 Atlantic Ave
Long Beach, CA 90813-4565

Mailing address

515 S Flower St FL 18
Los Angeles, CA 90071-2201

Other names 1

  • Serenity Atlantic Clinic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240508000972 CA Part A Provider - Federally Qualified Health Center (FQHC) 1658637202 Practice locations: Long Beach, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902663305. Details of each certification follow.

Federally qualified health center certification: CCN A01853

Legal name
SERENITY CARE HEALTH GROUP
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 21, 2024
Last certification
Mar 21, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 30, 2014 in CA
Enrollment address
780 Atlantic Ave
Long Beach, CA 90813-4565

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
05D2306113Serenity Care Health Group780 Atlantic Ave, FL 2, Long Beach, CA 90813Certificate of waiverJun 10, 2028

National Provider Directory

National Provider Directory
Tax ID family
Serenity Care Health Group6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

780 Atlantic Ave
Fl 2
Long Beach, CA 90813
Phone (562) 989-5722

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Bioseh Ogbechie Individual 5% Or Greater Direct Ownership Interest Mar 1, 2024
Arlene Medina Individual Corporate DirectorDir. of Exec Business Operations Jun 1, 2021
W-2 Managing Employee Jan 1, 2021

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1709251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1902663305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 S FLOWER ST FL 18",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900712201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908134565",
            "telephone_number": "562-573-3602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY CARE HEALTH GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-01",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "ARLENE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "562-478-4107"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serenity Atlantic Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Serenity Atlantic Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.