Healthcare Provider Details

I. General information

NPI: 1578362950
Provider Name (Legal Business Name): SERENE LIVING SPECIALTY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6126 JUNE AVE N
BROOKLYN CENTER MN
55429-2466
US

IV. Provider business mailing address

6126 JUNE AVE N
BROOKLYN CENTER MN
55429-2466
US

V. Phone/Fax

Practice location:
  • Phone: 612-471-4179
  • Fax:
Mailing address:
  • Phone: 612-471-4179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MAHAMED ABDULLAHI ALI AFRAH
Title or Position: OWNER
Credential:
Phone: 612-471-4179