Healthcare Provider Details

I. General information

NPI: 1093646226
Provider Name (Legal Business Name): BEVERLY MASON SERENITY LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

534 W VERNON AVE
LOS ANGELES CA
90037-2610
US

IV. Provider business mailing address

534 W VERNON AVE
LOS ANGELES CA
90037-2610
US

V. Phone/Fax

Practice location:
  • Phone: 213-801-5786
  • Fax:
Mailing address:
  • Phone: 213-801-5786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State

VIII. Authorized Official

Name: LAPHYEAL POPE
Title or Position: VICE PRESIDENT
Credential:
Phone: 213-801-5786