Organization
SERENIY FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ERICA TERESA FENNELL (OWNER)
(910) 337-2590
Entity
Organization
Contact information
Practice address
1436 BLAND SCHOOL RD, HARRELLS, NC 28444-7609
(910) 532-4805
(910) 532-2766
Mailing address
PO BOX 377, HARRELLS, NC 28444-0377
(910) 532-4805
(910) 532-2766
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
FCH-082-017
NC
3104A0625X
Assisted Living Facility (Mental Illness)
FCH-082-017
NC
Other
Enumeration date
03/31/2011
Last updated
03/31/2011
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