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General NPI Number Information
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NPI Number | 1770464240
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Entity Type | Organization
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Legal Business Name | SERENITY FAMILY AND COMMUNITY CTR
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Dates
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Enumeration Date | 09/10/2025
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Last Update Date | 09/21/2025
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Provider Practice Location Address
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Address Line | 1641 FRIENDSHIP RD
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City | SHELBY
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State | NC
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Zip | 28150-3222
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Country | US
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Telephone | 704-300-7707
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Fax |
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Provider Business Mailing Address
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Address Line | 1641 FRIENDSHIP RD
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City | SHELBY
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State | NC
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Zip | 28150-3222
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Country | US
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Telephone | 704-300-7077
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARICKEYIO HUSKEY
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Credential |
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Telephone | 704-300-7707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 385HR2050X
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Taxonomy Name | Respite Care Camp
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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