SERENITY FOR LIFE (NPI# 1710361969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710361969 |
| Entity Type | Organization |
| Organization Name | SERENITY FOR LIFE |
| Practice Address |
65 Pine Ave 360 Long Beach CA 90802 |
| Mailing Address |
65 Pine Ave 360 Long Beach CA 90802-4718 |
| Practice Telephone | 6267550003 |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2015-07-17 |
| Authorized Official Name | BENJAMIN F COREY (DUEL OWNER) |
| Authorized Official Telephone | 6267550003 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 190821AP | CA | Agencies |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Serenity For Life, LLC | 10200 E Kentucky Dr, Aurora, CO 80247-5206 |
| Street Address |
65 PINE AVE 360 |
| City | LONG BEACH |
| State | CA |
| Zip Code | 90802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013962273 | Diane L. Johnson | Internal Medicine | 65 Pine Ave, #19, Long Beach, CA 90802-4718 | 2006-05-24 |
| 1417191990 | Diane L. Johnson M.d. Inc | Internal Medicine | 65 Pine Ave, Suite 19, Long Beach, CA 90802-4718 | 2009-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255981791 | Nena Danieles Meador | Technician | 505 West 5th St. Unit 201, Long Beach, CA 90802 | 2019-09-17 |
| 1881241487 | Edward De La Cruz | Technician | 425 E 3rd St., 413, Long Beach, CA 90802 | 2019-08-20 |
| 1992350094 | Kaitlyn May Saephan | Student in an Organized Health Care Education/Training Program | 200 Pine Avenue, Suite 400, Long Beach, CA 90802 | 2019-08-06 |
| 1073175881 | David Coleman | Counselor | 735 West 4th St, Unit D, Long Beach, CA 90802 | 2019-07-01 |
| 1235612193 | Linda Nyagaya | Nurse Practitioner | 200 Oceangate, Suite 100 Long Beach, Ca 90802, Long Beach, CA 90802 | 2018-09-06 |
| 1669998670 | Jessica Huerta | Student in an Organized Health Care Education/Training Program | 456 Elm, Long Beach, CA 90802 | 2017-08-22 |
| 1316462484 | Kathlyn Pearl Parlet | Counselor | 351 E. 6th. Street, Long Beach, CA 90802 | 2017-08-09 |
| 1386168136 | Shena Young | Psychologist | 404 East First St #1191, Long Beach, CA 90802 | 2017-08-02 |
| 1215472758 | Vanessa Pons | Marriage & Family Therapist | 735 W 4th St Unit A, Long Beach, CA 90802 | 2016-12-19 |
| 1821459330 | Surabhi Shah | Occupational Therapist | 330 Golden Shores, Suite 250, Long Beach, CA 90802 | 2016-03-10 |
| Find all providers in zip 90802 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162616 | Bayfront Healthcare Services | Community/Behavioral Health | 2703 N Studebaker Rd, Long Beach, CA 90815-1628 | 2020-10-20 |
| 1174121529 | The Guidance Center | Community/Behavioral Health | 1450 Cedar Ave, Long Beach, CA 90813-1705 | 2020-10-16 |
| 1497353841 | The Guidance Center | Community/Behavioral Health | 750 Euclid Ave, Long Beach, CA 90804-5228 | 2020-10-16 |
| 1205434651 | The Guidance Center | Community/Behavioral Health | 1022 E Market St, Long Beach, CA 90805-6034 | 2020-10-16 |
| 1457959801 | The Guidance Center | Community/Behavioral Health | 1600 Atlantic Ave, Long Beach, CA 90813-2017 | 2020-10-16 |
| 1093313447 | The Guidance Center | Community/Behavioral Health | 1830 W Columbia St, Long Beach, CA 90810-2913 | 2020-10-16 |
| 1720686173 | The Guidance Center | Community/Behavioral Health | 1545 Long Beach Blvd, Long Beach, CA 90813-1923 | 2020-10-16 |
| 1235737883 | The Guidance Center | Community/Behavioral Health | 1175 E 11th St, Long Beach, CA 90813-3659 | 2020-10-15 |
| 1790383255 | The Guidance Center | Community/Behavioral Health | 3038 Delta Ave, Long Beach, CA 90810-2843 | 2020-10-15 |
| 1689272239 | The Guidance Center | Community/Behavioral Health | 1055 Freeman Ave, Long Beach, CA 90804-3804 | 2020-10-15 |
| Find all providers in LONG BEACH | ||||
| City | LONG BEACH |
| Zip Code | 90802 |
Please comment or provide details below to improve the information on SERENITY FOR LIFE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.