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General NPI Number Information
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NPI Number | 1578428199
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Entity Type | Organization
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Legal Business Name | SERENITY CARE GROUP
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Dates
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Enumeration Date | 12/16/2025
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 6980 AVALON WAY
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City | LEMON GROVE
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State | CA
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Zip | 91945-3447
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Country | US
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Telephone | 619-750-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 7484 UNIVERSITY AVE STE 330
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City | LA MESA
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State | CA
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Zip | 91942-6065
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Country | US
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Telephone | 619-750-8500
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ABDIKARIM A HUSSEIN
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Credential | ADMINISTRATOR
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Telephone | 619-750-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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