Serenity Home Corporation Inc.

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

MHL-092-809 Issued in NC

Legal business name

SERENITY HOME CORPORATION INC.

Practice address

511 S Bloodworth St
Raleigh, NC 27601-1947

Phone

(919) 900-8514

Fax

(919) 900-8514

NPI assigned

Mar 9, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Rose Marie Morales-Montoya

Title

Administrator/Owner

Phone

(919) 827-2473

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1299628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449446400000",
    "number": "1881992147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 S BLOODWORTH ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276011947",
            "telephone_number": "919-900-8514",
            "fax_number": "919-900-8514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 S BLOODWORTH ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276011947",
            "telephone_number": "919-900-8514",
            "fax_number": "919-900-8514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY HOME CORPORATION INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-09",
        "last_updated": "2015-12-07",
        "status": "A",
        "authorized_official_last_name": "MORALES-MONTOYA",
        "authorized_official_first_name": "ROSE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "919-827-2473",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "MHL-092-809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092809",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Serenity Outpatient Therapy Associates, PLLC
• Serenity PA Psychiatric Services PLLC

• Adult Care Home Facility in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Adult Care Home Facility in North Carolina

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