SERENITY MANOR ADULT DAY SERVICES, LLC (NPI# 1730721085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730721085 |
| Entity Type | Organization |
| Organization Name | SERENITY MANOR ADULT DAY SERVICES, LLC |
| Practice Address |
1319 Woodbridge Station Way Ste 102 Edgewood MD 21040-3852 |
| Practice Telephone | 4109948988 |
| Practice Fax Number | 4108445686 |
| Mailing Telephone | 4109948988 |
| Mailing Fax Number | 4108445686 |
| Enumeration Date | 2019-10-08 |
| Last Update Date | 2019-10-08 |
| Authorized Official Name | CAMILLE G. MATTHEWS (CEO) |
| Authorized Official Telephone | 4109948988 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA0600X |
Clinic/Center Specialization: Adult Day Care |
Ambulatory Health Care Facilities |
| Street Address |
1319 WOODBRIDGE STATION WAY STE 102 |
| City | EDGEWOOD |
| State | MD |
| Zip Code | 21040-3852 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629699293 | Sovereignty Health Services LLC | Physical Medicine & Rehabilitation | 1319 Woodbridge Station Way Ste 102, Edgewood, MD 21040-3852 | 2020-05-05 |
| 1821620758 | Craddles LLC | Occupational Therapy Assistant | 1319 Woodbridge Station Way Ste 102, Edgewood, MD 21040-3852 | 2020-02-09 |
| 1205467768 | Shakirat Olabisi Aroworowon | Occupational Therapy Assistant | 1319 Woodbridge Station Way Ste 102, Edgewood, MD 21040-3852 | 2020-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275028458 | Alycia Covelly | Counselor | 2415 Willoughby Beach Rd, Edgewood, MD 21040 | 2018-06-29 |
| 1558885491 | Kenneth J Heil Jr. | Physical Therapist | 1401f Pulaski Highway, Edgewood, MD 21040 | 2017-08-02 |
| 1952845810 | Caroline Njane | Registered Nurse | 835 Clover Leaf Ct, Edgewood, MD 21040 | 2016-12-12 |
| 1003368945 | Rts Edgewood | Clinic/Center | 2205 Pulaski Hwy, Edgewood, MD 21040 | 2016-10-26 |
| 1194133033 | Dante Winter | Pharmacist | 1301 Woodbridge Center Way, Edgewood, MD 21040 | 2014-07-23 |
| 1841469723 | Rafiq Patel M D P A | General Practice | 1952 Pulaski Highway, Edgewood, MD 21040 | 2008-02-26 |
| 1871793877 | Nichols Shelter Home for Elderly | Health Maintenance Organization | 1111 Hanson Rd., Edgewood, MD 21040 | 2007-07-19 |
| 1467505362 | William N Bernhard | Preventive Medicine | 2624 Fairview Pt Rd. Bldg E 6814, Aviation Medicine Clinic, Edgewood (apg), MD 21040 | 2007-01-22 |
| 1417006503 | Phoenix Recovery Center Inc | Clinic/Center | 107 Edgewood Rd, Edgewood, MD 21040 | 2007-01-09 |
| 1093886848 | Fernando Jose Narava | Dentist | 9690 Deereco, Suite 120, Timonium, MD 21040 | 2006-11-13 |
| Find all providers in zip 21040 | ||||
| Taxonomy Code | 261QA0600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Day Care |
| Definition to come... |
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| 1659910636 | Vitality 360 Inc | Clinic/Center | 2442 N Charles St, Baltimore, MD 21218-5113 | 2019-12-23 |
| 1487292678 | Vas Adult Day Care Center | Clinic/Center | 12621 Old Columbia Pike, Silver Spring, MD 20904 | 2019-12-18 |
| 1487208112 | Comfort Life Care Adult Medical Day Care | Clinic/Center | 11221 Dolfield Blvd Ste 100-101, Owings Mills, MD 21117-3254 | 2019-07-31 |
| 1538712625 | Liri Fusha | Clinic/Center | 8221 Richie Hwy Suit #102, Pasadena, MD 21122 | 2019-07-18 |
| 1073165619 | Aastha Amdc, LLC | Clinic/Center | 12210 Plum Orchard Dr Ste 214, Silver Spring, MD 20904-7913 | 2019-07-14 |
| 1992260079 | Links Residential Care Inc. | Clinic/Center | 6136 Landover Rd, Cheverly, MD 20785-1022 | 2019-02-04 |
| 1295214393 | Levindale Hebrew Geriatric Center & Hospital Inc | Clinic/Center | Lifebridge Health Adult Day Services, 5400 Old Court Road, Randallstown, MD 21133 | 2018-08-09 |
| 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.