SER (NPI# 1659636173) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659636173 |
| Entity Type | Organization |
| Organization Name | SER |
| Practice Address |
208 Leslie Dr Shelby NC 28152-0758 |
| Practice Telephone | 7046006480 |
| Practice Fax Number | 7046006480 |
| Mailing Telephone | 7046006480 |
| Mailing Fax Number | 7046006480 |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2012-07-10 |
| Authorized Official Name | MR. MARICKEYO SENTWAN HUSKEY (ADMINISTRATOR) |
| Authorized Official Telephone | 7046006710 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
NC | Nursing & Custodial Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SER | 1133 15th St Nw Ste 300, Washington, DC 20005-2710 |
| System for Award Management (SAM) Entities | SER & ASSOCIATES PLLC | 2100 Ponce De Leon Blvd Ste 1180, Coral Gables, FL 33134-5201 |
| Connecticut Business Registrations | Ser & Vic Construction LLC | 44 IRION ST, WATERBURY, CT |
| New York State Corporations | SER 1, LLC | 122 East 42nd Street, 18th Floor, New York, Ny 10168 |
| New York State Corporations | SER 10 SOUTH MAIN, LLC | 44 Church Street, White Plains, Ny 10601 |
| Washington State Corporations | SER 333 LLC | 1420 Fifth Ave Ste 4200, Seattle, WA 98101 |
| New York State Corporations | SER ACQUISITIONS LLC | 177a E Main Street, Suite 205, New Rochelle, Ny 10801 |
| New York State Corporations | SER ART LLC | Kings Point, New York 11024 |
| New York State Corporations | SER BALLARD INC. | 156 W 56th St, New York, Ny 10019 |
| New York State Corporations | SER BIG PICTURE LLC | 64 Hilton Avenue, Hempstead, Ny 11550 |
| Street Address |
208 LESLIE DR |
| City | SHELBY |
| State | NC |
| Zip Code | 28152-0758 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831720820 | The Kid Guru, LLC | Community/Behavioral Health | 6852 Landor Drive, Shelby, NC 28152 | 2020-01-29 |
| 1609370568 | Crossroads Treatment Center of Cleveland County, PC | Community/Behavioral Health | 1895 E Dixon Blvd, Shelby, NC 28152 | 2018-03-23 |
| 1184166944 | Collette Scruggs | Counselor | 200-2 South Post Road, Shelby, NC 28152 | 2016-11-10 |
| 1902277981 | Angela Hamilton Jones | Social Worker | 1243 East Dixon Blvd., Suite 4, Shelby, NC 28152 | 2015-10-15 |
| 1982002614 | Gillian Aloisia Squillacioti | Counselor | 1635 S Dekalb St, Apt 109, Shelby, NC 28152 | 2014-12-11 |
| 1578963765 | Lucy Mcdaniel | Nurse Practitioner | 200 South Post Road, Shelby, NC 28152 | 2014-08-26 |
| 1689086332 | Stanley Todd Bilin | Marriage & Family Therapist | 1243-4 East Dixon Blvd, Shelby, NC 28152 | 2014-05-29 |
| 1144512872 | Sydney M Phipps | Counselor | 1201 S Post Rd # 100, Shelby, NC 28152 | 2011-05-13 |
| 1659602928 | Katherine Ruthsatz Kjergaard | Physician Assistant | 105 East College Street, Shelby, NC 28152 | 2010-01-26 |
| 1407099229 | Cnc / Access, Inc. | Community/Behavioral Health | 1165 Country Home Road, Shelby, NC 28152 | 2009-04-09 |
| Find all providers in zip 28152 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760950570 | Lovy Family Care Home, Inc. | Custodial Care Facility | 1330 New House Rd, Shelby, NC 28150-7765 | 2018-11-09 |
| 1245684711 | Mccluney's Family Care Home | Custodial Care Facility | 837 W Warren St, Shelby, NC 28150-5064 | 2016-04-20 |
| 1396128757 | Serenity Living #2 | Custodial Care Facility | 113 Leslie Dr, Shelby, NC 28152-0757 | 2015-07-02 |
| 1740339126 | Shelby Manor Group Home | Custodial Care Facility | 1176 Wyke Rd, Shelby, NC 28150-4273 | 2007-01-09 |
| 1730326380 | Autum Year Family Care Home | Custodial Care Facility | 921 Surry Dr, Shelby, NC 28152-7140 | 2009-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162061 | Lewis E Williams | Custodial Care Facility | 1640 Bridgedale Dr, Rocky Mount, NC 27803-1604 | 2020-10-26 |
| 1861008583 | Arbor Landing At Hampstead LLC | Custodial Care Facility | 13937 Us Highway 17, Hampstead, NC 28443-4041 | 2020-09-17 |
| 1124645544 | Charlotte Sp Senior Housing Opco, LLC | Custodial Care Facility | 6041 Piedmont Row Drive, Charlotte, NC 28208 | 2020-07-01 |
| 1740804111 | Happy Hearts Group Home | Custodial Care Facility | 6255 Burlington Rd, Gibsonville, NC 27249-8783 | 2020-06-02 |
| 1730703422 | Graham 4 Enterprises | Custodial Care Facility | 3006 W Sedgefield Dr, Greensboro, NC 27407-7313 | 2020-05-29 |
| 1477177111 | C&s Adult Care LLC, Dba Deal Care Inn | Custodial Care Facility | 1075 Deal Rd, Mooresville, NC 28115-6719 | 2020-05-28 |
| 1114554516 | Cassandra Davis | Custodial Care Facility | 131 Huntington Rd, Louisburg, NC 27549 | 2020-03-25 |
| 1356975767 | Cornerstone Community Service | Custodial Care Facility | 2220 Southgate St, Durham, NC 27703-2102 | 2020-02-24 |
| 1477184653 | Rose Vista Assisted Living, LLC | Custodial Care Facility | 2130 Rose Vista Rd, Kinston, NC 28504-8230 | 2020-01-28 |
| 1104456011 | Regina Williams | Custodial Care Facility | 511 Tansy Drive, Charlotte, NC 28214 | 2020-01-20 |
| 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.