A Place of Serenity, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

067-01-434-1 Issued in GA

Legal business name

A PLACE OF SERENITY, INC.

Practice address

3755 Cherie Glen Rd
Snellville, GA 30039-4311

Phone

(770) 978-9501

Fax

(770) 982-4665

NPI assigned

Oct 3, 2010

Last updated

Mar 30, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Barbara Ann Clark-Beckford

Title

DDP/Admin.

Phone

(770) 865-1003

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1286064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522368000000",
    "number": "1164731576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3755 CHERIE GLEN RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300394311",
            "telephone_number": "470-545-3682",
            "fax_number": "770-972-3989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3755 CHERIE GLEN RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300394311",
            "telephone_number": "770-978-9501",
            "fax_number": "770-982-4665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A PLACE OF SERENITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-03",
        "last_updated": "2018-03-30",
        "status": "A",
        "authorized_official_last_name": "CLARK-BECKFORD",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DDP/ADMIN.",
        "authorized_official_telephone_number": "770-865-1003",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "067-01-434-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174304890A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2018; 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.