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General NPI Number Information
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NPI Number | 1275824492
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Entity Type | Organization
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Legal Business Name | SERENITY AT HOME, LLC
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Dates
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Enumeration Date | 04/21/2011
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Last Update Date | 04/21/2011
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Provider Practice Location Address
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Address Line | 28345 BECK RD SUITE 209
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City | WIXOM
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State | MI
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Zip | 48393-4733
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Country | US
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Telephone | 248-912-1030
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Fax | 248-912-1031
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Provider Business Mailing Address
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Address Line | 28345 BECK RD SUITE 209
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City | WIXOM
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State | MI
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Zip | 48393-4733
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Country | US
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Telephone | 248-912-1030
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Fax | 248-912-1031
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | TYRONE H RASHID
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Credential |
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Telephone | 248-912-1030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State | MI
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