Serenity Place Intervention Center, Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SERENITY PLACE INTERVENTION CENTER, INC

Practice address

140 Mine Lake CT Ste 100
Raleigh, NC 27615-6417

Phone

(984) 344-7320

Fax

(919) 518-8295

NPI assigned

Feb 17, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Peter Onuzulike Sr.

Title

Owner

Phone

(919) 847-3309

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 2

• SPIC MEDICAL EQUIPMENT SUPPLY Doing business as
• Serenity Place Intervention Center, Inc Doing business as

Tax ID family

Serenity Place Intervention Center Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Spic Medical Equipment Supply

  • Durable Medical Equipment & Medical Supplies
  • Raleigh, NC
  • NPI 1255198230
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1104419522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 MINE LAKE CT STE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276156417",
            "telephone_number": "919-847-3309",
            "fax_number": "919-518-8295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 MINE LAKE CT STE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276156417",
            "telephone_number": "984-344-7320",
            "fax_number": "919-518-8295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY PLACE INTERVENTION CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-17",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A",
        "authorized_official_last_name": "ONUZULIKE",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-847-3309",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00398687",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPIC MEDICAL EQUIPMENT SUPPLY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Serenity Place Intervention Center, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Serenity Home Corporation Inc.
• Serenity Incorporated
• Serenity Incorporated
• Serenity Incorporated
• Serenity PA Psychiatric Services PLLC
• Serenity Place Intervention Center, Inc
• Serenity Psychiatry of Raleigh, PLLC
• Serenity Seven Care Solutions LLC
• Heather Anne Serrano, AUD
• Yenifer Serrano, LCMHCA

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.