Organization
SERENITY LIVING #2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARICKEYO SENTWAN HUSKEY (ADMINSTRATOR)
(704) 300-7077
Entity
Organization
Contact information
Practice address
113 LESLIE DR, SHELBY, NC 28152-0757
(704) 487-5666
(704) 466-3043
Mailing address
113 SERENITY DR, SHELBY, NC 28152-7999
(704) 300-7077
(704) 466-3043
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL-023-046
NC
Other
Enumeration date
07/02/2015
Last updated
07/05/2015
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