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General NPI Number Information
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NPI Number | 1760889323
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Entity Type | Organization
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Legal Business Name | SERENITY CONGREGATE CARE
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Dates
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Enumeration Date | 11/25/2014
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Last Update Date | 11/04/2015
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Provider Practice Location Address
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Address Line | 31730 AVENIDA DEL PADRE
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City | CATHEDRAL CITY
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State | CA
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Zip | 92234
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Country | US
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Telephone | 760-321-8000
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Fax | 760-321-8002
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Provider Business Mailing Address
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Address Line | 13331 MOORPARK ST. #127
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City | SHERMAN OAKS
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State | CA
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Zip | 91423
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Country | US
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Telephone | 818-392-0226
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. MICHELLE MAGHALYAN
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Credential | MBA
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Telephone | 818-392-0226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | CA
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