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SERENITY LIVING SOLUTIONS OF BLACKDUCK LLC
NPI 1649087768
Assisted Living Facility in Blackduck, MN

Active since December 12, 2024CLIA 24D2083260 · Waiver
441 4TH ST NE, BLACKDUCK, MN 56630(651) 374-1619 Get Directions Write a Review

NPPES record last updated: December 12, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Serenity Living Solutions Of Blackduck Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SERENITY LIVING SOLUTIONS OF BLACKDUCK LLC (NPI 1649087768), doing business as Serenity Living Solutions Of Blackduck, is a healthcare organization registered as an assisted living facility in Blackduck, Minnesota and active in the NPI registry since December 2024. The organization holds a CLIA Waiver certificate valid through September 1, 2026 and lists Abdullahi Omar, President, as its authorized official.

NPPES Registry Identity

NPI1649087768
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameSERENITY LIVING SOLUTIONS OF BLACKDUCK LLC
Location Address441 4TH ST NEBlackduck, MN 56630-2167
Mailing Address2277 Highway 36 W Ste 300Roseville, MN 55113-3830 · (651) 374-1619
Phone(651) 374-1619
Organization SubpartNo
Authorized OfficialAbdullahi OmarPresident · (651) 374-1619
Enumeration DateDecember 12, 2024
NPPES CertifiedDecember 12, 2024
✔ NPI 1649087768 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
441 4TH ST NE, Blackduck, MN 56630
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Other Names 1

Doing Business AsSerenity Living Solutions Of Blackduck

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D2083260

Serenity Living Solutions Of Blackduck · Blackduck, MN
Active · expires Sep 1, 2026
CLIA Number24D2083260
Laboratory TypeAssisted Living Facility
Certificate Effective DateSeptember 2, 2024
Certificate Expiration DateSeptember 1, 2026
Laboratory DirectorKelly Douglas
Laboratory Phone(218) 835-4564
Laboratory LocationSerenity Living Solutions Of Blackduck441 4th St NE, Blackduck, MN 56630
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Serenity Living Solutions Of Blackduck LLC's NPI number?

The NPI number for Serenity Living Solutions Of Blackduck LLC is 1649087768. It was assigned to this organization in the NPPES registry on December 12, 2024. The provider is doing business as Serenity Living Solutions of Blackduck.

Where is Serenity Living Solutions Of Blackduck LLC located?

Serenity Living Solutions Of Blackduck LLC is located at 441 4th St NE, Blackduck, MN 56630. The listed phone number is (651) 374-1619.

What is Serenity Living Solutions Of Blackduck LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Serenity Living Solutions Of Blackduck LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2083260) is associated with this NPI, valid through September 1, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Serenity Living Solutions Of Blackduck LLC was last updated on December 12, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.