SERENITY LODGE, INC
NPI 1184914590
Substance Abuse Rehabilitation Facility in Lake Arrowhead, CA

NPI Status: Active since April 19, 2011

Contact Information

985 MEADOW BROOK RD
LAKE ARROWHEAD, CA
ZIP 92352
Phone: (909) 693-5127

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  • Organization
  • Substance Abuse Rehabilitation Facility
  • CLIA Number: 05D2073865
  • CLIA Cert. Type: Comp. Outpatient Rehab Facility
  • CLIA Exp. Date: 01-12-2027

About SERENITY LODGE, INC

This page provides the complete NPI Profile along with additional information for Serenity Lodge, Inc, a provider established in Lake Arrowhead, California operating as a Substance Abuse Rehabilitation Facility. The healthcare provider is registered in the NPI registry with number 1184914590 assigned on April 2011. The practitioner's primary taxonomy code is 324500000X with license number 360091AP (CA). The provider is registered as an organization and their NPI record was last updated 8 years ago. The authorized official of this NPI record is Matthew Joseph Baldo (Compliance Manager)

NPI
1184914590
Provider Name
SERENITY LODGE, INC
Entity Type
Organization
Location Address
985 MEADOW BROOK RD LAKE ARROWHEAD, CA 92352
Location Phone
(909) 693-5127
Mailing Address
PO BOX 2895 LAKE ARROWHEAD, CA 92352
Mailing Phone
(888) 244-0898
Mailing Fax
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-19-2011
Last Update Date
05-07-2018
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Substance Abuse Rehabilitation Facility

Taxonomy Code
324500000X
Type
Residential Treatment Facilities
License No.
360091AP
License State
CA
Taxonomy Description
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MATTHEW JOSEPH BALDO

Authorized Official Title
COMPLIANCE MANAGER
Authorized Official Phone
(909) 693-5127

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D2073865
Facility Type
Comp. Outpatient Rehab Facility
Certificate Effective Date
January 13, 2025
Certificate Expiration Date
January 12, 2027
Laboratory Director
VALEH S. KARIMKHANI DO
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Serenity Lodge, Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1184914590, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 70. The final step is to find the difference between that total and the next multiple of ten (70 - 70 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
4
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
1
Unchanged
Pos 7
4
Doubled → 8
Pos 8
5
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 9 → 18 → 9 4 → 8 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 6 + 4 + 1 + 8 + 1 + 8 + 5 + 1 + 8 + 24 = 70

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 70 is 70. The difference is the calculated check digit.

70 - 70 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1184914590.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1184914590, enumerated as an "organization" on April 19, 2011.

The provider is located at 985 MEADOW BROOK RD LAKE ARROWHEAD, CA 92352 and the phone number is (909) 693-5127.

Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.