NPI Code Details Logo

NPI 1164384590

NPI 1164384590 : A&A SERENITY HOMES LLC : REDFORD, MI

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1164384590
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    A&A SERENITY HOMES LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    11/24/2025
-----------------------------------------------------
    Last Update Date     |    11/24/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    14020 MINOCK DR 
-----------------------------------------------------
    City                 |    REDFORD
-----------------------------------------------------
    State                |    MI
-----------------------------------------------------
    Zip                  |    48239-2935
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    313-477-3299
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    16629 ARDMORE ST 
-----------------------------------------------------
    City                 |    DETROIT
-----------------------------------------------------
    State                |    MI
-----------------------------------------------------
    Zip                  |    48235-4093
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    313-477-3299
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER/PROVIDER
-----------------------------------------------------
    Name                 |     ANDREA JANEY BEY 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    313-477-3299
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    174200000X
-----------------------------------------------------
    Taxonomy Name        |    Meals Provider
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    177F00000X
-----------------------------------------------------
    Taxonomy Name        |    Lodging Provider
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    251E00000X
-----------------------------------------------------
    Taxonomy Name        |    Home Health Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
    Taxonomy Code        |    251S00000X
-----------------------------------------------------
    Taxonomy Name        |    Community/Behavioral Health Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
    Taxonomy Code        |    253J00000X
-----------------------------------------------------
    Taxonomy Name        |    Foster Care Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #6
-----------------------------------------------------
    Taxonomy Code        |    310400000X
-----------------------------------------------------
    Taxonomy Name        |    Assisted Living Facility
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #7
-----------------------------------------------------
    Taxonomy Code        |    3104A0625X
-----------------------------------------------------
    Taxonomy Name        |    Assisted Living Facility (Mental Illness)
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #8
-----------------------------------------------------
    Taxonomy Code        |    3104A0630X
-----------------------------------------------------
    Taxonomy Name        |    Assisted Living Facility (Behavioral Disturbances)
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #9
-----------------------------------------------------
    Taxonomy Code        |    320600000X
-----------------------------------------------------
    Taxonomy Name        |    Intellectual and/or Developmental Disabilities Residential Treatment Facility
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #10
-----------------------------------------------------
    Taxonomy Code        |    320700000X
-----------------------------------------------------
    Taxonomy Name        |    Physical Disabilities Residential Treatment Facility
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #11
-----------------------------------------------------
    Taxonomy Code        |    320800000X
-----------------------------------------------------
    Taxonomy Name        |    Mental Illness Community Based Residential Treatment Facility
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #12
-----------------------------------------------------
    Taxonomy Code        |    320900000X
-----------------------------------------------------
    Taxonomy Name        |    Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #13
-----------------------------------------------------
    Taxonomy Code        |    324500000X
-----------------------------------------------------
    Taxonomy Name        |    Substance Abuse Rehabilitation Facility
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #14
-----------------------------------------------------
    Taxonomy Code        |    385H00000X
-----------------------------------------------------
    Taxonomy Name        |    Respite Care
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #15
-----------------------------------------------------
    Taxonomy Code        |    253Z00000X
-----------------------------------------------------
    Taxonomy Name        |    In Home Supportive Care Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.