Serenity Rehabilitation and Therapy, LLC.

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

SERENITY REHABILITATION AND THERAPY, LLC.

Practice address

3405 Sweetwater Rd 422
Lawrenceville, GA 30044-3004

Phone

(561) 889-8812

NPI assigned

Dec 19, 2024

Organization subpart

No

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

Authorized official

Name

Miss Nishelle Antoinette Thimote-Heraldo, OTR

Title

Ceo/Member

Phone

(561) 889-8812

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1734566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734566400000",
    "number": "1821806068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 SWEETWATER RD 422",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300443004",
            "telephone_number": "561-889-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 SWEETWATER RD 422",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300443004",
            "telephone_number": "561-889-8812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY REHABILITATION AND THERAPY, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-19",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A",
        "authorized_official_last_name": "THIMOTE-HERALDO",
        "authorized_official_first_name": "NISHELLE",
        "authorized_official_middle_name": "ANTOINETTE",
        "authorized_official_title_or_position": "CEO/MEMBER",
        "authorized_official_telephone_number": "561-889-8812",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Comprehensive Outpatient Rehabilitation Facility (CORF) in Lawrenceville, GA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.