Healthcare Provider Details

I. General information

NPI: 1043130610
Provider Name (Legal Business Name): SERENITY RESIDENTIAL HOMES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4815 W CRITTENDEN LN
PHOENIX AZ
85031-3145
US

IV. Provider business mailing address

3722 E ORCHID CT
GILBERT AZ
85296-8268
US

V. Phone/Fax

Practice location:
  • Phone: 480-200-9183
  • Fax: 480-383-6280
Mailing address:
  • Phone: 480-200-9183
  • Fax: 480-383-6280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: SAIDA MOHAMED
Title or Position: OWNER
Credential:
Phone: 480-200-9183