SERENITY HOME OF MARICOPA .LLC


Address: 43350 W Elizabeth Ave, Maricopa, AZ 85138-5716
Phone: 5204317587

SERENITY HOME OF MARICOPA .LLC (NPI# 1831506328) 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) 1831506328
Entity Type Organization
Organization Name SERENITY HOME OF MARICOPA .LLC
Practice Address 43350 W Elizabeth Ave
Maricopa
AZ 85138-5716
Mailing Address 41282 W Capistrano Dr
Maricopa
AZ 85138-4591
Practice Telephone 5204317587
Mailing Telephone 5204317587
Enumeration Date 2014-07-16
Last Update Date 2014-07-16
Authorized Official Name MS. VIVIAN WRIGHT (EXECUTIVE DIRECTOR)
Authorized Official Telephone 5204317587
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 322D00000X Residential Treatment Facility, Emotionally Disturbed Children BH4439 AZ Residential Treatment Facilities

Office Location

Street Address 43350 W ELIZABETH AVE
City MARICOPA
State AZ
Zip Code 85138-5716

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1982202594 Olugus Family Care Psychologist 44077 W. Palmen Dr., Maricopa, AZ 85138 2020-10-15
1154960722 Walgreen Co Durable Medical Equipment & Medical Supplies 41840 W Maricopa- Casa Grande Hwy, Maricopa, AZ 85138 2019-12-31
1780227413 Gabriela Flores Registered Nurse 44150 W. Maricopa Casa Grande Hwy, Maricopa, AZ 85138 2019-10-25
1033752761 Lizabeth Joy Stephens Registered Nurse 44150 West Maricopa-casa Grand Hwy., Maricopa, AZ 85138 2019-10-25
1922657964 Cathy Jo Rogers Registered Nurse 18600 North Porter Road, Maricopa, AZ 85138 2019-09-11
1902463565 Four Directions LLC Respite Care 37724 W Amalfi Ave, Maricopa, AZ 85138 2019-05-20
1972087013 Kristina Donnay Family Medicine 41600 W Smith Enke Rd Ste 3, Maricopa, AZ 85138 2018-09-24
1861909657 Four Directions LLC Respite Care 43989 W Wade Drive, Maricopa, AZ 85138 2018-01-03
1063939411 Christina Kern Specialist/Technologist 42623 W. Colby Dr., Maricopa, AZ 85138 2017-08-26
1205357191 Konadu Family Community Based Residential Treatment Facility, Mental Illness 40030 W Coltin Way, Maricopa, AZ 85138 2017-06-29
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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
1528666039 Rehoboth LLC Residential Treatment Facility, Emotionally Disturbed Children 46136 W Mountain View Rd # A, Maricopa, AZ 85139-6796 2020-10-16
1407333958 Copa's Caring Hands LLC. Residential Treatment Facility, Emotionally Disturbed Children 42251 W Bravo Dr, Maricopa, AZ 85138-2295 2018-07-26
1366978462 Tamla Alexander Residential Treatment Facility, Emotionally Disturbed Children 43284 W Arizona Ave, Maricopa, AZ 85138-8236 2017-05-10
1184154072 Day Starz Group Home, Inc. Residential Treatment Facility, Emotionally Disturbed Children 43284 W Arizona Ave, Maricopa, AZ 85138 2017-06-14

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
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
1487118865 Serenity Preferred LLC Residential Treatment Facility, Emotionally Disturbed Children 17829 W Columbine Dr, Surprise, AZ 85388-5628 2019-01-30
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
1144740572 Tree of Life Arizona LLC Residential Treatment Facility, Emotionally Disturbed Children 2935 E Dartmouth St, Mesa, AZ 85213-6907 2017-06-27
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Competitor

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City MARICOPA
Zip Code 85138

Improve Information

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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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