SERENITY OF WILSON HOME CARE INC. (NPI# 1669736252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669736252 |
| Entity Type | Organization |
| Organization Name | SERENITY OF WILSON HOME CARE INC. |
| Practice Address |
4004 Eclipse Way Wilson NC 27896-7801 |
| Mailing Address |
2704 Barrington Dr N Wilson NC 27896-8852 |
| Practice Telephone | 2526747294 |
| Practice Fax Number | 2522811048 |
| Mailing Telephone | 2522821048 |
| Mailing Fax Number | 2522811048 |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2012-06-27 |
| Authorized Official Name | RAVEN JANEEN BARNES (OWNER/DIRECTOR) |
| Authorized Official Telephone | 2522811048 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | MHL-098-179 | NC | Residential Treatment Facilities |
| Street Address |
4004 ECLIPSE WAY |
| City | WILSON |
| State | NC |
| Zip Code | 27896-7801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528543972 | Realo Discount Drug Stores of Eastern North Carolina, Inc | Durable Medical Equipment & Medical Supplies | 3724 Raleigh Road Parkway, Suite A, Wilson, NC 27896 | 2018-10-02 |
| 1518450865 | Alysann Brooke Price | Social Worker | 5878 Farmwood Loop, Wilson, NC 27896 | 2018-06-12 |
| 1144744517 | Sara Lynn Campbell | Physical Therapist | 3200 Nash Street North, Wilson, NC 27896 | 2017-07-27 |
| 1902327109 | Lamont Zebediah Barnett | Counselor | 3904 Airport Drive, Wilson, NC 27896 | 2017-06-28 |
| 1578014718 | Kristy Kaye Rowland | Counselor | 3707 Marion Court N, Wilson, NC 27896 | 2016-10-24 |
| 1780058057 | Marsha Ricketts Harper | Occupational Therapy Assistant | 3105 Senior Village Lane, Wilson, NC 27896 | 2015-11-24 |
| 1508122615 | Charlotte Hurt | Social Worker | 910 Raleigh Rd Parkway, Wilson, NC 27896 | 2012-04-03 |
| 1447542139 | Sarah Elizabeth Kirby Bischoff | Pharmacist | 3401 Raleigh Rd, Harris Teeter, Wilson, NC 27896 | 2011-05-12 |
| 1235462342 | Wilson Medical Group | Non-Pharmacy Dispensing Site | 3302 Nash St North, Wilson, NC 27896 | 2009-09-09 |
| 1164662466 | My Friend's House, LLC | Community Based Residential Treatment Facility, Mental Illness | 3607 Columbia Avenue, Wilson, NC 27896 | 2009-02-26 |
| Find all providers in zip 27896 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578840567 | Davis Family Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6604 E Us 264 Alt, Wilson, NC 27893 | 2011-11-04 |
| 1972807915 | Gentle Hands | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1615 Washington St E, Wilson, NC 27893-5561 | 2011-01-05 |
| 1801121181 | Harvest Care of North Carolina, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1513 Forest Hills Rd Nw, Wilson, NC 27896-1553 | 2009-10-05 |
| 1891922217 | Supreme Love | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4232 Coghill Dr N, Wilson, NC 27896-9503 | 2009-06-11 |
| 1386884518 | Myles's Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 909 Gold St N, Wilson, NC 27893-2509 | 2009-02-27 |
| 1164606505 | A Better Way of Life Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 103 Belmont Ave Sw, Wilson, NC 27893-4701 | 2007-12-20 |
| 1871772731 | Amandla Enterprises Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 111 Nash St W # 204, Wilson, NC 27893-4012 | 2007-10-29 |
| 1780704213 | Wanda H. Hinton | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 306 North Ave N, Apt A, Wilson, NC 27893-2454 | 2007-03-29 |
| 1194843839 | Carolyn Diane Perry | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 108 Stadium St Sw, Wilson, NC 27893-4749 | 2007-03-27 |
| 1821129040 | Wilson County Residential Services,inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 115 B West Hines St, Wilson, NC 27893-3924 | 2007-03-08 |
| Find all providers in WILSON | ||||
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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.