SERENITY PREFERRED LLC


Address: 17829 W Columbine Dr, Surprise, AZ 85388-5628
Phone: 6232341177

SERENITY PREFERRED LLC (NPI# 1487118865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1487118865
Entity Type Organization
Organization Name SERENITY PREFERRED LLC
Practice Address 17829 W Columbine Dr
Surprise
AZ 85388-5628
Practice Telephone 6232341177
Mailing Telephone 6232341177
Enumeration Date 2019-01-30
Last Update Date 2019-01-30
Authorized Official Name ADEBOLA A ADARALEGBE (PROGRAM DIRECTOR)
Authorized Official Telephone 6235232297
Authorized Official Credential MBA
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 322D00000X Residential Treatment Facility, Emotionally Disturbed Children Residential Treatment Facilities

Office Location

Street Address 17829 W COLUMBINE DR
City SURPRISE
State AZ
Zip Code 85388-5628

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NPI Name Taxonomy Address Enumeration
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1881118867 Haja Sankoh Behavior Technician 16645 West Central St, Surprise, AZ 85388 2017-08-01
1235516675 Benjamin J Hegenbarth Family Medicine 14981 Nth 174 Dr., Surprise, AZ 85388 2015-05-06
1447644521 Urgent Care Centers of Arizona, LLC Clinic/Center 16840 W. Waddell Road, Suite 110, Surprise, AZ 85388 2015-03-26
1548512239 We Care Medical Supply Plus Durable Medical Equipment & Medical Supplies 17317 W. Banff Lane, Surprise, AZ 85388 2012-10-05
1376871095 Rebecca Kimberly Adamoli Nurse's Aide 17999 N. Surprise Farms Loop South, Surprise, AZ 85388 2009-11-19
1417281395 Tracy Dunbar Respite Care 18245 West Port Royale Ln., Surprise, AZ 85388 2009-09-25
1467696617 Eileen Georgina Soltis Registered Nurse 17359 W. Surprise Farms Loop N, Surprise, AZ 85388 2009-04-30
1538306360 Wholistic Integrative Caring Network LLC Nurse Practitioner 16278 N. 164th Lane, Surprise, AZ 85388 2009-01-15
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Taxonomy Information

Taxonomy Code 322D00000X
Grouping Residential Treatment Facilities
Classification Residential Treatment Facility, Emotionally Disturbed Children

Taxonomy Definition

A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment.
Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1649452251 Community Network and Fellow Residential Treatment Facility, Emotionally Disturbed Children 14019 N 149th Dr, Surprise, AZ 85379-6012 2007-12-05
1306979083 Trinity Group Homes Residential Treatment Facility, Emotionally Disturbed Children 17022 W Rimrock St, Surprise, AZ 85388-1533 2007-03-13

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1528666039 Rehoboth LLC Residential Treatment Facility, Emotionally Disturbed Children 46136 W Mountain View Rd # A, Maricopa, AZ 85139-6796 2020-10-16
1962022665 New Hope of Arizona, Inc. Residential Treatment Facility, Emotionally Disturbed Children 8710 W Watkins St, Tolleson, AZ 85353-9028 2020-04-22
1639798143 Anthony Udoinwang Residential Treatment Facility, Emotionally Disturbed Children 10435 W Reade Ave, Glendale, AZ 85307-4237 2020-04-14
1033756358 Native Music Coalition Residential Treatment Facility, Emotionally Disturbed Children 5150 S Crazy Cat Ln, Tucson, AZ 85735 2019-12-05
1013558311 Back To Life Incorporated Residential Treatment Facility, Emotionally Disturbed Children 6420 W Cocopah St, Phoenix, AZ 85043 2019-10-08
1407333958 Copa's Caring Hands LLC. Residential Treatment Facility, Emotionally Disturbed Children 42251 W Bravo Dr, Maricopa, AZ 85138-2295 2018-07-26
1538668983 Starks Homes LLC Residential Treatment Facility, Emotionally Disturbed Children 7325 E Fayette St, Tucson, AZ 85730-2324 2018-02-12
1881100147 Anna Marie Barrios Residential Treatment Facility, Emotionally Disturbed Children 18811 N 7th Dr, Phoenix, AZ 85027-5508 2017-12-22
1033625926 Youth Transition Services, Inc. Residential Treatment Facility, Emotionally Disturbed Children 1190 S Boulder St Unit D, Gilbert, AZ 85296-3792 2017-12-14
1538681374 Rey Ash Residential Facility LLC Residential Treatment Facility, Emotionally Disturbed Children 3765 W Yellow Peak Dr, San Tan Valley, AZ 85142-3090 2017-07-13
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Competitor

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City SURPRISE
Zip Code 85388

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Dataset Information

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.

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