Healthcare Provider Details

I. General information

NPI: 1679459770
Provider Name (Legal Business Name): SERENITY IN HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2025
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23916 MICHIGAN AVE STE 310
DEARBORN MI
48124-1833
US

IV. Provider business mailing address

23916 MICHIGAN AVE STE 310 SUITE 310
DEARBORN MI
48124-1833
US

V. Phone/Fax

Practice location:
  • Phone: 313-734-0565
  • Fax: 313-734-0328
Mailing address:
  • Phone: 313-734-0565
  • Fax: 313-734-0328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SAM BAZZI
Title or Position: OFFICE MANAGER
Credential:
Phone: 313-734-0565