SERENITY ASSISTED LIVING LLC NPI 1568304855

NPI Information

  • NPI: 1568304855
  • Provider Name: SERENITY ASSISTED LIVING LLC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Address: 206 PINE ST
    SPARKS, GA
    ZIP 31647
  • Phone: (229) 549-6620

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NPI Details

SERENITY ASSISTED LIVING LLC is an assisted living facility in Sparks, GA. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. SERENITY ASSISTED LIVING LLC NPI is 1568304855. The provider is registered as an organization entity type.

The provider's business location address is:

206 PINE ST
SPARKS, GA
ZIP 31647-422
Phone: (229) 549-6620

The provider's authorized official is James Pettis .
The authorized official title is President and has the following contact phone number (478) 714-0246.

The enumeration date for this NPI number is 4/7/2026 and was last updated on 4/7/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1046652606AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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