Healthcare Provider Details

I. General information

NPI: 1508351131
Provider Name (Legal Business Name): SERENE CONGREGATE LIVING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2018
Last Update Date: 06/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 CONCORD LN
REDLANDS CA
92374-6445
US

IV. Provider business mailing address

812 CONCORD LN
REDLANDS CA
92374-6445
US

V. Phone/Fax

Practice location:
  • Phone: 909-478-4001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: ELEANOR POSNER
Title or Position: DIRECTOR OF NURSING
Credential:
Phone: 818-281-5822