SERENITY SUPPORTED LIVING (NPI# 1427322742) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427322742 |
| Entity Type | Organization |
| Organization Name | SERENITY SUPPORTED LIVING |
| Practice Address |
201 E Pitt St Suite 208-209 Tarboro NC 27886-5192 |
| Mailing Address |
216 John Ave Greenville NC 27858-4112 |
| Practice Telephone | 2528230555 |
| Mailing Telephone | 2527549963 |
| Mailing Fax Number | 2527549964 |
| Enumeration Date | 2012-03-05 |
| Last Update Date | 2012-03-05 |
| Authorized Official Name | MRS. CAMILLAE' TAWNYANETTA WORTHINGTON (CEO/OWNER) |
| Authorized Official Telephone | 2528230555 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Street Address |
201 E PITT ST SUITE 208-209 |
| City | TARBORO |
| State | NC |
| Zip Code | 27886-5192 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720225014 | Prosource Therapeutics, LLC | Counselor | 201 E Pitt St, Tarboro, NC 27886-5192 | 2009-01-08 |
| 1720453228 | Sinclair Institute of Transformational Care LLC | Substance Abuse Rehabilitation Facility | 201 E Pitt St, Suite 201, Tarboro, NC 27886-5192 | 2015-12-09 |
| 1083989156 | New Life Community Services, LLC | Community/Behavioral Health | 201 E Pitt St, Suite 101, Tarboro, NC 27886-5192 | 2012-03-21 |
| 1568789311 | Good Kids Therapeutic Reources | Community/Behavioral Health | 201 E Pitt St, Ste 207-208 (edgecombe Prof. Bldg), Tarboro, NC 27886-5192 | 2010-05-03 |
| 1982934501 | Life Enhancement Services | Case Management | 201 E Pitt St, Suite 102, Tarboro, NC 27886-5192 | 2010-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336781566 | Fountain Transportation | Non-emergency Medical Transport (VAN) | 350 William Walston Lane, Tarboro, NC 27886 | 2019-10-09 |
| 1942737481 | Jude Ude | Pharmacist | 1519 Man Street, Tarboro, NC 27886 | 2017-05-15 |
| 1487197406 | Fms Ena Home, LLC | Clinic/Center | 122 Hospital Drive, Tarboro, NC 27886 | 2016-11-22 |
| 1295191450 | Fountain Adult Home Care, LLC | Custodial Care Facility | 303 William Walston Lane, Tarboro, NC 27886 | 2016-01-04 |
| 1033464805 | Tiffany Chapman Barber | Pharmacist | 1519 N Main Street, Tarboro, NC 27886 | 2012-07-18 |
| 1891085247 | Illumi-nation Care Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7806 Hwy 42 East, Tarboro, NC 27886 | 2011-04-19 |
| 1376842187 | Hiren C Patel | Pharmacist | 1600 North Main St., Tarboro, NC 27886 | 2011-03-18 |
| 1407976590 | Edgecombe Chiropractic Inc | Chiropractor | 1801 Main Street, Tarboro, NC 27886 | 2007-03-30 |
| 1265567762 | Rinson A Weathers | Personal Emergency Response Attendant | 111 Hospital Drive, Tarboro, NC 27886 | 2007-02-23 |
| 1780758961 | George Thomas Ward | Dentist | 112 W St John Street, Tarboro, NC 27886 | 2006-11-20 |
| Find all providers in zip 27886 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891085247 | Illumi-nation Care Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7806 Hwy 42 East, Tarboro, NC 27886 | 2011-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306455126 | A Place 4 Me, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5305 Clearwater Lake Rd, Mount Holly, NC 28120-1445 | 2020-07-28 |
| 1922623792 | Our Home At Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4601 Waterford Knoll Dr Apt 1724, Charlotte, NC 28226-6015 | 2020-06-08 |
| 1922634484 | Tracey Holton | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Easterseals Ucp, 913 Carolina Ave N, Statesville, NC 28677 | 2020-03-17 |
| 1710443395 | Unity 4 Us Community Outreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 406 Lincoln St, Belmont, NC 28012-3045 | 2019-02-19 |
| 1871059444 | Believing Everyone Succeeds Together | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 323 Shady Grove Rd, Kings Mtn, NC 28086-9671 | 2019-02-19 |
| 1740744283 | Tri Plex Industries Corp | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9635 Southern Pine Blvd Ste 154, Charlotte, NC 28273-5564 | 2019-01-29 |
| 1316415037 | Igr Collaborations | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 212 Pine Ridge Dr, Roanoke Rapids, NC 27870-6832 | 2018-11-12 |
| 1164924940 | David Douglas Whitfield | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5342 Us Highway 301 North, Micro, NC 27555 | 2018-03-07 |
| 1710489976 | Moravian Enterprises, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 122 North Elm St., Suite 810, Greensboro, NC 27401 | 2018-03-05 |
| 1659897833 | Shelby Day Program | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 621 S Dekalb St Ste A, Shelby, NC 28150-6189 | 2017-08-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.