SERENITY RESIDENTIAL HOME CARE (NPI# 1518312404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518312404 |
| Entity Type | Organization |
| Organization Name | SERENITY RESIDENTIAL HOME CARE |
| Practice Address |
1129 N Harvard Ave Oklahoma City OK 73127-4021 |
| Mailing Address |
214 Sw 30th St Oklahoma City OK 73109-6506 |
| Practice Telephone | 4059463341 |
| Practice Fax Number | 4052721630 |
| Mailing Telephone | 4053617643 |
| Mailing Fax Number | 4052721630 |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2016-04-28 |
| Authorized Official Name | MR. TIMOTHY LEE SHOALS SR. (OWNER) |
| Authorized Official Telephone | 4053617643 |
| Authorized Official Credential | BS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities |
| Street Address |
1129 N HARVARD AVE |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73127-4021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598176711 | We Care LLC | Respite Care | 5400 Nw 23rd Street, Suite 100, Oklahoma City, OK 73127 | 2014-05-09 |
| 1437494655 | Dr. Yong H. Kim, Psyd, Professional Limited Company | Psychologist | 8101 Nw 10th, Oklahoma City, OK 73127 | 2012-11-28 |
| 1952652836 | Kevin Kent Shelton Sr. | Behavioral Analyst | 2120 East Harlow Place, Oklahoma City, OK 73127 | 2012-10-02 |
| 1548537962 | Recovercare LLC | Durable Medical Equipment & Medical Supplies | 6620 Melrose Ln., Oklahoma City, OK 73127 | 2011-11-30 |
| 1326370065 | Karen Lou Gault | Counselor | 7201 N. W. 10th, Okc, OK 73127 | 2010-02-05 |
| 1679708762 | Aerocare Home Medical Equipment, Inc. | Durable Medical Equipment & Medical Supplies | 6125 W Reno Ave Ste 100, Oklahoma City, OK 73127 | 2009-05-19 |
| 1306068432 | Emerald Square Assisted Living, LLC | Assisted Living Facility | 701 North Council Road, Oklahoma City, OK 73127 | 2007-05-02 |
| 1447377585 | Occupational Health Centers of The Southwest, P.a. | Clinic/Center | 6101 West Reno, Suite 800, Oklahoma City, OK 73127 | 2007-03-23 |
| 1811021165 | Carmellia Marie Hamilton | Registered Nurse | 4913 W. Reno, Oklahoma City, OK 73127 | 2007-03-16 |
| 1447345178 | Tim Guinn | Pharmacist | 4911 N.w. 23rd Street, Oklahoma City, OK 73127 | 2006-10-04 |
| Find all providers in zip 73127 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376075051 | Servant Living Center - Beggs, LLC | Custodial Care Facility | 511 N Chippewa, Beggs, OK 74421-2053 | 2017-03-31 |
| 1497294714 | Joyce Faye's House | Custodial Care Facility | 2126 Meench Dr, Moore, OK 73170-7494 | 2017-02-20 |
| 1366780280 | A Place Close To Home Adult Day Care | Custodial Care Facility | 12220 S State Highway 51, Coweta, OK 74429-7169 | 2013-01-28 |
| 1457620221 | 202 Haley Inc. | Custodial Care Facility | 2911 N Grand St, Enid, OK 73701-1320 | 2011-12-22 |
| 1801170139 | Jenesis Care Homes, Inc | Custodial Care Facility | 8234 S Sandusky Ave, Tulsa, OK 74137-1833 | 2011-10-05 |
| 1699121020 | A Brighter Light Residential Care Home LLC | Custodial Care Facility | 2708 S Hemlock Ave, Broken Arrow, OK 74012-0817 | 2016-05-04 |
| 1841577905 | Spanish Cove Housing Authority | Custodial Care Facility | 11 Palm Ave, Yukon, OK 73099-5645 | 2011-11-03 |
| City | OKLAHOMA CITY |
| Zip Code | 73127 |
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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.