NPIMap

Organization Active NPI

Serenity Community Mental Health Center LLC

  • Community/Behavioral Health Agency
  • Saint Cloud, FL
National Provider Identifier
1952077539
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SERENITY COMMUNITY MENTAL HEALTH CENTER LLC
Practice address
3505 Progress LN
Saint Cloud, FL 34769-6519
Phone
(786) 534-8366
NPI assigned
Aug 23, 2021
Last updated
Aug 23, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SERENITY COMMUNITY MENTAL HEALTH CENTER LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Authorized official

Name
Yadira Santana
Title
Ceo
Phone
(786) 534-8366

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

3505 Progress LN
Saint Cloud, FL 34769-6519

Mailing address

3505 Progress LN
Saint Cloud, FL 34769-6519

Other identifiers 1

IdentifierTypeStateIssuer
7865348366OtherPHONE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170124001453 FL Part B Supplier - Clinic/Group Practice 4587946793 Receives reassigned benefits from 20 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Saint Cloud, FL; West Palm Beach, FL; Tampa, FL; Pembroke Pines, FL; Miami, FL

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Serenity Community Mental Health Center LLC7 organizations share this tax ID, including this one
Part of
Serenity Community Mental Health Center LLC

Other organizations with this tax ID 6

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

Locations

110 Century Blvd
Ste 200
West Palm Beach, FL 33417
Phone (561) 282-2960

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": "1629676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629676800000",
    "number": "1952077539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 PROGRESS LN",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347696519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 PROGRESS LN",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347696519",
            "telephone_number": "786-534-8366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY COMMUNITY MENTAL HEALTH CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SERENITY COMMUNITY MENTAL HEALTH CENTER LLC",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A",
        "authorized_official_last_name": "SANTANA",
        "authorized_official_first_name": "YADIRA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "786-534-8366"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHONE NUMBER",
            "identifier": "7865348366",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.