SERENITY GARDENS REHAB (NPI# 1376097923) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376097923 |
| Entity Type | Organization |
| Organization Name | SERENITY GARDENS REHAB |
| Practice Address |
5830 Cohasset Way San Jose CA 95123-3710 |
| Mailing Address |
678 Wisconsin St San Francisco CA 94107-2734 |
| Practice Telephone | 6505209148 |
| Mailing Telephone | 6505209148 |
| Enumeration Date | 2016-08-12 |
| Last Update Date | 2017-04-25 |
| Authorized Official Name | AMY DALLI (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6505209148 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Street Address |
5830 COHASSET WAY |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95123-3710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700441045 | Calvin Patrick Nell | Chiropractor | 5570 Sanchez Drive, Ste 100, San Jose, CA 95123 | 2019-05-02 |
| 1629557152 | Jia Tian | Dentist | 393 Blossom Hill Rd Ste 150, San Jose, CA 95123 | 2018-08-06 |
| 1003306176 | Western Dental Services, Inc. | Dentist | 451 Blossom Hill Rd Suite 20, San Jose, CA 95123 | 2018-05-15 |
| 1871004945 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 5411 Thornwood Dr, San Jose, CA 95123 | 2017-10-17 |
| 1437672953 | Mie Mie Chiu | Dietitian, Registered | 276 Palm Valley Blvd #205, San Jose, CA 95123 | 2017-07-18 |
| 1902335300 | Alfredo Fernandez | Counselor | 5898 Paddon Circle, San Jose, CA 95123 | 2017-06-08 |
| 1780115444 | Christopher Vi Tran | Case Manager/Care Coordinator | 5579 Lean Avenue, San Jose, CA 95123 | 2017-03-24 |
| 1205370004 | Linxi Wu | Acupuncturist | 6064 Cahalan Ave, San Jose, CA 95123 | 2016-12-13 |
| 1013307651 | Kevin Dizon | Dental Hygienist | 6071 Sunstone Drive, San Jose, CA 95123 | 2015-02-04 |
| 1285031294 | Katie Tran | Dental Assistant | 524 Glenburry Way, San Jose, CA 95123 | 2014-11-20 |
| Find all providers in zip 95123 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174188239 | Synthesis Recovery LLC | Substance Abuse Rehabilitation Facility | 5498 Blackoak Way, San Jose, CA 95129-3110 | 2019-05-04 |
| 1407355548 | Telecare Copration | Substance Abuse Rehabilitation Facility | 298 Bernal Rd Ste B, San Jose, CA 95119-1809 | 2018-02-05 |
| 1073048716 | New Life Recovery Centers, Inc. | Substance Abuse Rehabilitation Facility | 1101 Park Ave, San Jose, CA 95126-2911 | 2017-05-01 |
| 1437684172 | New Life Recovery Centers, Inc. | Substance Abuse Rehabilitation Facility | 166 Clayton Ave., San Jose, CA 95110-2229 | 2017-05-01 |
| 1659818441 | Red Road Treatment, Inc | Substance Abuse Rehabilitation Facility | 421 N 13th St, San Jose, CA 95112-1720 | 2017-01-31 |
| 1841656964 | Pathway Society Inc | Substance Abuse Rehabilitation Facility | 2390 Lucretia Ave, 1106, San Jose, CA 95122-4215 | 2016-01-05 |
| 1760850945 | Wellness Recovery Retreat Center | Substance Abuse Rehabilitation Facility | 10615 Crothers Rd, San Jose, CA 95127-1728 | 2015-09-04 |
| 1124396627 | Pathway Society Inc. | Substance Abuse Rehabilitation Facility | 861 S 10th St, San Jose, CA 95112-2434 | 2011-12-12 |
| 1558639161 | Pathway Society Inc | Substance Abuse Rehabilitation Facility | 850 E Empire St, San Jose, CA 95112-1707 | 2011-12-09 |
| 1619245354 | Pathway Society Inc | Substance Abuse Rehabilitation Facility | 526 E San Fernando St, San Jose, CA 95112-2001 | 2011-12-08 |
| Find all providers in SAN JOSE | ||||
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| 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.