CENTURY OAKS SERENITY, LLC (NPI# 1699219345) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699219345 |
| Entity Type | Organization |
| Organization Name | CENTURY OAKS SERENITY, LLC |
| Other Organization Name | CENTURY OAKS ALF |
| Practice Address |
4001 Stack Blvd Melbourne FL 32901-8500 |
| Practice Telephone | 3217224440 |
| Mailing Telephone | 3217224440 |
| Enumeration Date | 2016-12-15 |
| Last Update Date | 2016-12-15 |
| Authorized Official Name | LON STECKLER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9547480509 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 10095 | FL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Century Oaks ALF | Doing Business As Name - Organization |
| Street Address |
4001 STACK BLVD |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-8500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093832305 | Rafael Cales IIi | Physical Therapy Assistant | 4001 Stack Blvd, Melbourne, FL 32901-8500 | 2007-03-23 |
| 1922474576 | Valentina Lopez | Physical Therapy Assistant | 4001 Stack Blvd, Melbourne, FL 32901-8500 | 2015-08-18 |
| 1275917791 | Nakita Bernadette Knowles | Physical Therapist | 4001 Stack Blvd, Melbourne, FL 32901-8500 | 2015-07-14 |
| 1760881361 | Josephine Ogoe | Occupational Therapy Assistant | 4001 Stack Blvd, Melbourne, FL 32901-8500 | 2014-08-19 |
| 1013342799 | Melissa Alba | Occupational Therapist | 4001 Stack Blvd, Melbourne, FL 32901-8500 | 2013-09-12 |
| 1427176601 | Pamela Lynn Miller | Occupational Therapy Assistant | 4001 Stack Blvd, Melbourne, FL 32901-8500 | 2007-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922512656 | Chakiah Tucker Mitchell | Assisted Living Facility | 2421 Lipscomb St, Melbourne, FL 32901-5572 | 2017-11-16 |
| 1619329422 | Assisted Lovely Living Facility LLC | Assisted Living Facility | 1702 Trimble Rd, Melbourne, FL 32934-9034 | 2016-07-05 |
| 1770948853 | Allcia LLC | Assisted Living Facility | 4457 Parkway Dr, Melbourne, FL 32934-7767 | 2015-12-16 |
| 1760885784 | House of Light Senior Living IIi | Assisted Living Facility | 2306 Woodlawn Cir, Melbourne, FL 32934-7645 | 2014-10-04 |
| 1891100996 | Enclave Assisted Living II | Assisted Living Facility | 2518 Bernice Ct, Melbourne, FL 32935-3415 | 2014-06-26 |
| 1386072858 | Ginnys Place II | Assisted Living Facility | 2251 Turtle Mound Rd, Melbourne, FL 32934-7650 | 2013-10-21 |
| 1194153676 | Ginnys Place of Suntree | Assisted Living Facility | 730 Whispering Pines Cir, Melbourne, FL 32940-7831 | 2013-10-21 |
| 1457787962 | Grammys House Corp | Assisted Living Facility | 3401 Lakewood Dr, Melbourne, FL 32904-5206 | 2013-09-17 |
| 1043644495 | Florida Assisted Living Homes LLC | Assisted Living Facility | 2204 Parsons Ave, Melbourne, FL 32901-5234 | 2013-08-21 |
| 1831535616 | Guyco Senior Living Concepts | Assisted Living Facility | 2400 New York St, Melbourne, FL 32904-6230 | 2013-05-20 |
| Find all providers in MELBOURNE | ||||
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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.