MEDICARE: SERENE SENIOR HOMECARE 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1730012071
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENE SENIOR HOMECARE LLC

Provider Business Mailing Address
First Line	:	22430 GRATIOT AVE
Second Line	:	P.O BOX 690
City	:	EASTPOINTE
State	:	MI
Zip	:	48021-7048
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2161 E BIG BEAVER RD APT 105
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48083-2384
Country	:	US
Telephone Number	:	248-991-4968
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	TIERRA SAWYER
Credential	:
Telephone Number	:	248-991-4968

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/05/2026

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