NPIMap

Organization Active NPI

Serenityhomecare

  • Adult Care Home Facility
  • Clinton, MS
National Provider Identifier
1215315528
Registry record updated May 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
DOMO5355 Issued in MS
Legal business name
SERENITYHOMECARE
Practice address
1512 Clinton Raymond Rd
Clinton, MS 39056-5400
Phone
(601) 942-9401
NPI assigned
May 7, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2015

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

Authorized official

Name
Ms. Shaunena Irene Staple
Title
Pca
Phone
(601) 942-9401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X DOMO5355 MS Primary

Addresses

Primary practice location

1512 Clinton Raymond Rd
Clinton, MS 39056-5400

Mailing address

1512 Clinton Raymond Rd
Clinton, MS 39056-5400
Phone (601) 942-9401

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1430956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430956800000",
    "number": "1215315528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 CLINTON RAYMOND RD",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390565400",
            "telephone_number": "601-942-9401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 CLINTON RAYMOND RD",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390565400",
            "telephone_number": "601-942-9401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITYHOMECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-07",
        "last_updated": "2015-05-07",
        "status": "A",
        "authorized_official_last_name": "STAPLE",
        "authorized_official_first_name": "SHAUNENA",
        "authorized_official_middle_name": "IRENE",
        "authorized_official_title_or_position": "PCA",
        "authorized_official_telephone_number": "601-942-9401",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MS",
            "license": "DOMO5355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2015; 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.