Provider Demographics
NPI:1376986919
Name:SERENITY- A NEW HOPE ASSISTED LIVING COMMUNITY
Entity Type:Organization
Organization Name:SERENITY- A NEW HOPE ASSISTED LIVING COMMUNITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LEVI
Authorized Official - Middle Name:
Authorized Official - Last Name:BIAS
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:678-596-0935
Mailing Address - Street 1:1418 SPRING ST SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-3639
Mailing Address - Country:US
Mailing Address - Phone:678-228-1665
Mailing Address - Fax:
Practice Address - Street 1:1418 SPRING ST SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-3639
Practice Address - Country:US
Practice Address - Phone:678-228-1665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-14
Last Update Date:2013-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility