Organization
SERENITY INCORPORATED
Active
Parent organization
SERENITY INCORPORATED
Other names
Serenity Place
Organization subpart
Yes
Provider details
NPI number
Legal business name
SERENITY INCORPORATED
Authorized official
MRS. CLARICE SHYLLON FAULKNER RN (PRESIDENT)
(919) 771-9173
Entity
Organization
Contact information
Practice address
7901 OLD STAGE RD, RALEIGH, NC 27603-5519
(919) 771-9173
(919) 367-0816
Mailing address
PO BOX 1583, CARY, NC 27512-1583
(919) 771-9173
(919) 367-0816
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
MHL-092-396
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7803874
—
NC
Enumeration date
02/27/2007
Last updated
06/30/2008
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