Organization
SERENITY INCORPORATED
Active
Parent organization
SERENITY INCORPORATED
Other names
Serenity Place V
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
1002 WILSHIRE DR, CARY, NC 27511-3921
(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-092-501
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804600
—
NC
Enumeration date
02/27/2007
Last updated
06/30/2008
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