SERENITYHOMECARE (NPI# 1215315528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215315528 |
| Entity Type | Organization |
| Organization Name | SERENITYHOMECARE |
| Practice Address |
1512 Clinton Raymond Rd Clinton MS 39056-5400 |
| Practice Telephone | 6019429401 |
| Mailing Telephone | 6019429401 |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2015-05-07 |
| Authorized Official Name | MS. SHAUNENA IRENE STAPLE (PCA) |
| Authorized Official Telephone | 6019429401 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
DOMO5355 | MS | Nursing & Custodial Care Facilities |
| Street Address |
1512 CLINTON RAYMOND RD |
| City | CLINTON |
| State | MS |
| Zip Code | 39056-5400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376012724 | John Melvin Goolsby Jr. | Dentist | 457 Highway 80 East, Clinton, MS 39056 | 2018-11-15 |
| 1225534530 | Magnolia Allergy Clinic LLC | Internal Medicine | 402 Cynthia St Ste E, Clinton, MS 39056 | 2018-04-04 |
| 1578093704 | Melinda A Weisenberger | Specialist/Technologist | 4600 W Northside Drive, Clinton, MS 39056 | 2017-06-20 |
| 1962859702 | Telehealthone, LLC | Nurse Practitioner | 200 Clinton Plaza, Clinton, MS 39056 | 2016-05-23 |
| 1841686581 | 1st America Infusion Services LLC | Durable Medical Equipment & Medical Supplies | 132 Fairmont Street, Suite B, Clinton, MS 39056 | 2015-04-09 |
| 1023412822 | Rebecca Brooks Prewitt | Social Worker | 130 B Fairmont Street, Clinton, MS 39056 | 2014-10-22 |
| 1396184149 | Robert Joseph Hargis | Urology | 116 Afton Way, Clinton, MS 39056 | 2013-06-14 |
| 1750626321 | Clinton Dental Care, Inc. | Dentist | 736 Clinton Pkwy, Clinton, MS 39056 | 2012-12-07 |
| 1922394469 | Daphenia C. Knight Starling | Nurse Practitioner | Clinton Healthcare, 1251 Pinehaven Rd, Clinton, MS 39056 | 2011-06-23 |
| 1134443385 | Gwendolyn Coleman Garror | Pharmacist | 132 Fairmount Drive, Clinton, MS 39056 | 2010-03-17 |
| Find all providers in zip 39056 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| 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. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871777037 | Safe Haven Care, LLC | Custodial Care Facility | 9613 Plank Road, Suite O, Clinton, LA 70722 | 2007-12-24 |
| 1447452024 | Duplin Sampson Group Homes, Inc. | Custodial Care Facility | 300 Jacobs St, Clinton, NC 28328-3539 | 2007-06-05 |
| 1659580470 | Pine Acre Family Care Home #2 | Custodial Care Facility | 156 Pine Acres Ln, Clinton, NC 28328-7390 | 2007-05-21 |
| 1295943140 | Pine Acre Family Care Home #1 | Custodial Care Facility | 186 Pine Acres Ln, Clinton, NC 28328-7390 | 2007-05-21 |
| 1669551438 | Lutheran Home of Central New York | Custodial Care Facility | 108 Utica Rd, Clinton, NY 13323-1548 | 2006-11-03 |
| 1952965667 | K & J Care Enterprises, Inc. | Custodial Care Facility | 614 S Main St, Clinton, MO 64735-2620 | 2019-04-28 |
| 1104000272 | Safe Haven Care, LLC | Custodial Care Facility | 9613 Plank Road, Suite O, Clinton, LA 70722 | 2007-12-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912540428 | Jennifer Lashon May | Custodial Care Facility | 141 Jefferson Street Ste, C, Monticello, MS 39654-3965 | 2019-10-28 |
| 1255866059 | Personal Touch LLC | Custodial Care Facility | 614 Chippewah Dr, Laurel, MS 39443-7413 | 2017-04-29 |
| 1164964003 | Creative Image Personal Care Service LLC | Custodial Care Facility | 503 Highway 82 E, Indianola, MS 38751-2317 | 2016-11-09 |
| 1679943310 | Educare Senior Day Center (vicksburg Branch) | Custodial Care Facility | 3202 Wisconsin Ave, Vicksburg, MS 39180-5351 | 2015-10-06 |
| 1659747988 | Aging Gracefully Community Center | Custodial Care Facility | 16165 Highway 51, Hazlehurst, MS 39083-2002 | 2015-08-20 |
| 1356765101 | Healthyland Adult Day Care, LLC | Custodial Care Facility | 227 Pecan Street, Marks, MS 38646 | 2014-02-14 |
| 1164845210 | R S Enterprise | Custodial Care Facility | 532 Burns St, Jackson, MS 39203-3601 | 2014-01-26 |
| 1053746487 | Assurance Home Care Agency LLC | Custodial Care Facility | 1549 Shiloh Church Rd, Newton, MS 39345-9024 | 2013-09-04 |
| 1790119519 | Pressicare, Inc | Custodial Care Facility | 20434 Old Houston Rd, Aberdeen, MS 39730-8548 | 2013-08-28 |
| 1295084325 | The Way of Life Adult Day Care Inc | Custodial Care Facility | 1356 Newport Rd, Lexington, MS 39095-5869 | 2012-09-05 |
| Find all providers with the same taxonomy | ||||
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| 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.