NPIMap

Organization Active NPI

Serenity Keepers of Maryland LLC

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
National Provider Identifier
1134731284
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
SERENITY KEEPERS OF MARYLAND LLC
Practice address
3645 Cottage Ave
Baltimore, MD 21215-7725
Phone
(704) 605-0927
NPI assigned
Aug 20, 2020
Last updated
Mar 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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

Authorized official

Name
Ms. Nikki Corbin
Title
Owner
Phone
(704) 605-0927

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

3645 Cottage Ave
Baltimore, MD 21215-7725

Mailing address

2640 Oswego Ave
Baltimore, MD 21215-7037
Phone (704) 999-8627

National Provider Directory

National Provider Directory
Tax ID family
Serenity Keepers of Maryland LLC2 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.

NPI Registry JSON

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646956800000",
    "number": "1134731284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 OSWEGO AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212157037",
            "telephone_number": "704-999-8627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3645 COTTAGE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212157725",
            "telephone_number": "704-605-0927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY KEEPERS OF MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-20",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A",
        "authorized_official_last_name": "CORBIN",
        "authorized_official_first_name": "NIKKI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-605-0927",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.