Serenity Manor Adult Day Services, LLC

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

SERENITY MANOR ADULT DAY SERVICES, LLC

Practice address

1319 Woodbridge Station Way Ste 102
Edgewood, MD 21040-3852

Phone

(410) 994-8988

Fax

(410) 844-5686

NPI assigned

Oct 8, 2019

Organization subpart

No

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

Authorized official

Name

Camille G. Matthews

Title

Ceo

Phone

(410) 994-8988

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570492800000",
    "number": "1730721085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 WOODBRIDGE STATION WAY STE 102",
            "city": "EDGEWOOD",
            "state": "MD",
            "postal_code": "210403852",
            "telephone_number": "410-994-8988",
            "fax_number": "410-844-5686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 WOODBRIDGE STATION WAY STE 102",
            "city": "EDGEWOOD",
            "state": "MD",
            "postal_code": "210403852",
            "telephone_number": "410-994-8988",
            "fax_number": "410-844-5686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY MANOR ADULT DAY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-08",
        "last_updated": "2019-10-08",
        "status": "A",
        "authorized_official_last_name": "MATTHEWS",
        "authorized_official_first_name": "CAMILLE",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-994-8988"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Day Care Clinic/Center in Edgewood, MD
• Providers in Edgewood, MD by specialty
• Adult Day Care Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.