Serene Village Home Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

SERENE VILLAGE HOME CARE LLC

Practice address

579 Simonton Oak LN
Lawrenceville, GA 30045-3525

Phone

(678) 557-6174

NPI assigned

Feb 1, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Teria Kai CorbinNPI 1891566105

Title

Ceo

Phone

(678) 557-6174

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Teria K Corbin

  • In Home Supportive Care Agency
  • Lawrenceville, GA
  • NPI 1891566105
  NPD Authorized official

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

{
    "created_epoch": "1706745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706745600000",
    "number": "1598528689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579 SIMONTON OAK LN",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300453525",
            "telephone_number": "678-557-6174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 SIMONTON OAK LN",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300453525",
            "telephone_number": "678-557-6174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENE VILLAGE HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-01",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A",
        "authorized_official_last_name": "CORBIN",
        "authorized_official_first_name": "TERIA",
        "authorized_official_middle_name": "KAI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-557-6174",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• In Home Supportive Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.