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General NPI Number Information
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NPI Number | 1144011883
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Entity Type | Organization
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Legal Business Name | SERENITY HOMES LLC
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 805 MICHIGAN AVE # 53172
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City | SOUTH MILWAUKEE
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State | WI
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Zip | 53172-2646
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Country | US
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Telephone | 414-791-6045
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Fax |
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Provider Business Mailing Address
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Address Line | 5066 S 14TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53221-3536
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ABDULLAHI MOHAMED
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Credential |
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Telephone | 414-791-6045
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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License Number State |
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