Healthcare Provider Details
I. General information
NPI: 1972429009
Provider Name (Legal Business Name): SERENITY PATH LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1520 CONGRESS AVE
SAGINAW MI
48602-5125
US
IV. Provider business mailing address
1520 CONGRESS AVE
SAGINAW MI
48602-5125
US
V. Phone/Fax
- Phone: 616-309-3008
- Fax:
- Phone: 616-309-3008
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVESHIA
E
HIBBLER
Title or Position: OWNER
Credential: CNA
Phone: 616-309-3008