SERENITY LIVING #2


Address: 113 Leslie Dr, Shelby, NC 28152-0757
Phone: 7044875666

SERENITY LIVING #2 (NPI# 1396128757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1396128757
Entity Type Organization
Organization Name SERENITY LIVING #2
Practice Address 113 Leslie Dr
Shelby
NC 28152-0757
Mailing Address 113 Serenity Dr
Shelby
NC 28152-7999
Practice Telephone 7044875666
Practice Fax Number 7044663043
Mailing Telephone 7043007077
Mailing Fax Number 7044663043
Enumeration Date 2015-07-02
Last Update Date 2015-07-05
Authorized Official Name MR. MARICKEYO SENTWAN HUSKEY (ADMINSTRATOR)
Authorized Official Telephone 7043007077
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 311ZA0620X Custodial Care Facility
Specialization: Adult Care Home
FCL-023-046 NC Nursing & Custodial Care Facilities

Office Location

Street Address 113 LESLIE DR
City SHELBY
State NC
Zip Code 28152-0757

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1831720820 The Kid Guru, LLC Community/Behavioral Health 6852 Landor Drive, Shelby, NC 28152 2020-01-29
1609370568 Crossroads Treatment Center of Cleveland County, PC Community/Behavioral Health 1895 E Dixon Blvd, Shelby, NC 28152 2018-03-23
1184166944 Collette Scruggs Counselor 200-2 South Post Road, Shelby, NC 28152 2016-11-10
1902277981 Angela Hamilton Jones Social Worker 1243 East Dixon Blvd., Suite 4, Shelby, NC 28152 2015-10-15
1982002614 Gillian Aloisia Squillacioti Counselor 1635 S Dekalb St, Apt 109, Shelby, NC 28152 2014-12-11
1578963765 Lucy Mcdaniel Nurse Practitioner 200 South Post Road, Shelby, NC 28152 2014-08-26
1689086332 Stanley Todd Bilin Marriage & Family Therapist 1243-4 East Dixon Blvd, Shelby, NC 28152 2014-05-29
1144512872 Sydney M Phipps Counselor 1201 S Post Rd # 100, Shelby, NC 28152 2011-05-13
1659602928 Katherine Ruthsatz Kjergaard Physician Assistant 105 East College Street, Shelby, NC 28152 2010-01-26
1407099229 Cnc / Access, Inc. Community/Behavioral Health 1165 Country Home Road, Shelby, NC 28152 2009-04-09
Find all providers in zip 28152

Taxonomy Information

Taxonomy Code 311ZA0620X
Grouping Nursing & Custodial Care Facilities
Classification Custodial Care Facility
Specialization Adult Care Home

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1760950570 Lovy Family Care Home, Inc. Custodial Care Facility 1330 New House Rd, Shelby, NC 28150-7765 2018-11-09
1245684711 Mccluney's Family Care Home Custodial Care Facility 837 W Warren St, Shelby, NC 28150-5064 2016-04-20
1659636173 Ser Custodial Care Facility 208 Leslie Dr, Shelby, NC 28152-0758 2012-07-10
1740339126 Shelby Manor Group Home Custodial Care Facility 1176 Wyke Rd, Shelby, NC 28150-4273 2007-01-09
1730326380 Autum Year Family Care Home Custodial Care Facility 921 Surry Dr, Shelby, NC 28152-7140 2009-01-17

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1578162061 Lewis E Williams Custodial Care Facility 1640 Bridgedale Dr, Rocky Mount, NC 27803-1604 2020-10-26
1861008583 Arbor Landing At Hampstead LLC Custodial Care Facility 13937 Us Highway 17, Hampstead, NC 28443-4041 2020-09-17
1124645544 Charlotte Sp Senior Housing Opco, LLC Custodial Care Facility 6041 Piedmont Row Drive, Charlotte, NC 28208 2020-07-01
1740804111 Happy Hearts Group Home Custodial Care Facility 6255 Burlington Rd, Gibsonville, NC 27249-8783 2020-06-02
1730703422 Graham 4 Enterprises Custodial Care Facility 3006 W Sedgefield Dr, Greensboro, NC 27407-7313 2020-05-29
1477177111 C&s Adult Care LLC, Dba Deal Care Inn Custodial Care Facility 1075 Deal Rd, Mooresville, NC 28115-6719 2020-05-28
1114554516 Cassandra Davis Custodial Care Facility 131 Huntington Rd, Louisburg, NC 27549 2020-03-25
1356975767 Cornerstone Community Service Custodial Care Facility 2220 Southgate St, Durham, NC 27703-2102 2020-02-24
1477184653 Rose Vista Assisted Living, LLC Custodial Care Facility 2130 Rose Vista Rd, Kinston, NC 28504-8230 2020-01-28
1104456011 Regina Williams Custodial Care Facility 511 Tansy Drive, Charlotte, NC 28214 2020-01-20
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Competitor

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City SHELBY
Zip Code 28152

Improve Information

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Dataset Information

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.

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