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General NPI Number Information
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NPI Number | 1245177021
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Entity Type | Organization
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Legal Business Name | SERENITY VILLAGE ASSISTED LIVING
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Dates
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Enumeration Date | 04/30/2026
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Last Update Date | 04/30/2026
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Provider Practice Location Address
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Address Line | 113 SERENITY CT
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City | AVON
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State | MN
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Zip | 56310-4541
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Country | US
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Telephone | 320-844-8880
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Fax | 763-201-5991
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Provider Business Mailing Address
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Address Line | 113 SERENITY CT
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City | AVON
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State | MN
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Zip | 56310-4541
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Country | US
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Telephone |
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Fax | 763-201-5991
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | STEPHANIE FRYER
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Credential | LALD
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Telephone | 763-300-7875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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