CSM SERENITY HOMES, LLC (NPI# 1235607854) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235607854 |
| Entity Type | Organization |
| Organization Name | CSM SERENITY HOMES, LLC |
| Practice Address |
1714 W 32nd St Holland MI 49423-7311 |
| Practice Telephone | 6162987698 |
| Practice Fax Number | 6162987426 |
| Mailing Telephone | 6162987698 |
| Mailing Fax Number | 6162987426 |
| Enumeration Date | 2018-11-13 |
| Last Update Date | 2018-11-13 |
| Authorized Official Name | JENNY CLARK (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6168941962 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Serenity Homes West | Other Name - Individual/Organization |
| Street Address |
1714 W 32ND ST |
| City | HOLLAND |
| State | MI |
| Zip Code | 49423-7311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356996714 | Ella Rose Marx | Social Worker | 412 Century Lane, Holland, MI 49423 | 2019-08-02 |
| 1245720424 | Amanda Ann Allen | Behavior Technician | 165 Sorrento Drive, Holland, MI 49423 | 2018-05-14 |
| 1588194237 | Emily Amila Geurink | Physical Therapy Assistant | 4037 43rd St, Holland, MI 49423 | 2017-06-15 |
| 1285081737 | Kara Draayer | Nurse Anesthetist, Certified Registered | 25 W 8th St Ste 200, Holland, MI 49423 | 2016-05-14 |
| 1851776413 | Sara Ty | Occupational Therapist | 789 South Meadow Court, Holland, MI 49423 | 2015-07-24 |
| 1508243056 | Andrew Peasley | Chiropractor | 436 Century Ln., Holland, MI 49423 | 2015-05-05 |
| 1437536497 | Deborah Donnelly | Physical Therapy Assistant | 1221 16th Street, Holland, MI 49423 | 2015-04-29 |
| 1366846024 | John Nguyen | Pharmacist | 747 E 16th St, Holland, MI 49423 | 2014-10-09 |
| 1003257817 | Courtney Young | Social Worker | 96 W 15 Street Midtown Center- Arbor Circle, Holland, MI 49423 | 2013-07-09 |
| 1689014391 | Jason Pettet | Acupuncturist | 500 West 17th St., Holland, MI 49423 | 2013-06-26 |
| Find all providers in zip 49423 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083237051 | Twin Doves I LLC | Community Based Residential Treatment Facility, Mental Illness | 48617 36th Ave., Bangor, MI 49013 | 2020-05-25 |
| 1104452812 | New Vision of Integrative Services, Inc | Community Based Residential Treatment Facility, Mental Illness | 3505 Walnut St Ste C, Inkster, MI 48141-2952 | 2020-03-14 |
| 1124665054 | Baseline, L.L.C. | Community Based Residential Treatment Facility, Mental Illness | 122 W Crosstown Pkwy, Kalamazoo, MI 49001-2742 | 2019-12-10 |
| 1407491277 | Twin Doves II LLC | Community Based Residential Treatment Facility, Mental Illness | 40739 80th Ave, Decatur, MI 49045-8158 | 2019-11-15 |
| 1710528617 | Larry J Graham Jr. | Community Based Residential Treatment Facility, Mental Illness | 1284 Maurer Ave, Pontiac, MI 48342-1960 | 2019-10-01 |
| 1447815469 | Rainbow Rehabilitation Centers, Inc. | Community Based Residential Treatment Facility, Mental Illness | 6200 Textile Rd, Ypsilanti, MI 48197 | 2019-05-06 |
| 1669937603 | Community Living Options | Community Based Residential Treatment Facility, Mental Illness | 1206 Bronson Cir, Kalamazoo, MI 49008-2325 | 2019-02-04 |
| 1750859229 | The Noble Home II, Inc | Community Based Residential Treatment Facility, Mental Illness | 327 E Grand Blvd, Detroit, MI 48207-3616 | 2018-11-02 |
| 1679048870 | Neighborhood Living Services,inc. | Community Based Residential Treatment Facility, Mental Illness | 23001 Norfolk St, Detroit, MI 48219-1185 | 2018-10-04 |
| 1851875371 | People Community of Michigan Afc Homes, Inc. | Community Based Residential Treatment Facility, Mental Illness | 16829 Monica St, Detroit, MI 48221-2969 | 2018-09-20 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on CSM SERENITY HOMES, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.