MEDICARE: SERENITY HOMES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311Z00000X	Custodial Care Facility

General Provider Information

NPI Number	:	1144011883
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITY HOMES LLC

Provider Business Mailing Address
First Line	:	5066 S 14TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53221-3536
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	805 MICHIGAN AVE # 53172
Second Line	:
City	:	SOUTH MILWAUKEE
State	:	WI
Zip	:	53172-2646
Country	:	US
Telephone Number	:	414-791-6045
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ABDULLAHI MOHAMED
Credential	:
Telephone Number	:	414-791-6045

Provider Enumeration Date	:	05/13/2025
Last Update Date	:	05/13/2025

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Directions to “SERENITY HOMES LLC ” Practice Location

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