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General NPI Number Information
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NPI Number | 1851143218
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Entity Type | Organization
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Legal Business Name | SERENITY COMFORT AND CARE
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Dates
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Enumeration Date | 04/01/2024
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Last Update Date | 04/01/2024
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Provider Practice Location Address
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Address Line | 3719 LATROBE DR STE 810
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City | CHARLOTTE
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State | NC
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Zip | 28211-5300
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Country | US
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Telephone | 980-221-0064
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Fax | 833-733-1249
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Provider Business Mailing Address
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Address Line | 2125 SOUTHEND DR APT 320
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City | CHARLOTTE
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State | NC
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Zip | 28203-5056
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Country | US
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Telephone | 980-318-7046
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Fax | 833-733-1249
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Authorized Official
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Title or Position | OWNER LICENSED CLINICIAL SOCIAL WOR
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Name | MS. WANDA RENEE MCWILLIAMS
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Credential | LCSW
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Telephone | 980-318-7049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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