Organization · Type 2 NPI

Serenity Incorporated

Adult Care Home Facility · Raleigh, NC

NPI number 1013044247 Active

Practice location

5005 Hollyridge Dr
Raleigh, NC 27612-3109

Call (919) 771-9173 Map

Fax (919) 367-0816

Mailing address

PO Box 1583
Cary, NC 27512-1583

Specialties and licenses

Taxonomy	Code	License
Adult Care Home Facility Primary	311ZA0620X	MHL-092-443 (NC)

Adult Care Home Facility: A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

Another provider at this address

Destiny Family Care HomeIntellectual and/or Developmental Disabilities Residential Treatment Facility Raleigh, NC NPI 1063734564

Other adult care home facility providers in Raleigh

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NPI record

NPI: 1013044247
Entity type: Organization (Type 2)
Issued: Feb 27, 2007
Last updated: Jun 30, 2008
Status: Active
Subpart: Yes of Serenity Incorporated

Other names

<unavail>
Serenity Place III · doing business as

Authorized official

Mrs. Clarice Shyllon Faulkner, RN
President
(919) 771-9173

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1013044247

Serenity Incorporated's National Provider Identifier is 1013044247, issued on Feb 27, 2007. The primary taxonomy on file is Adult Care Home Facility (311ZA0620X), and the practice location is in Raleigh, NC. The record was last updated on Jun 30, 2008.