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General NPI Number Information
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NPI Number | 1417323098
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Entity Type | Organization
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Legal Business Name | SERENITY HOSPICE OF MICHIGAN
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Dates
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Enumeration Date | 08/18/2015
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Last Update Date | 08/18/2015
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Provider Practice Location Address
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Address Line | 6942 DIXIE HWY
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City | BRIDGEPORT
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State | MI
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Zip | 48722-9760
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Country | US
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Telephone | 734-644-0303
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Fax |
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Provider Business Mailing Address
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Address Line | 5366 W ROLLING HILLS DR
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City | BRIDGEPORT
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State | MI
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Zip | 48722-9671
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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 | ADMINISTRATOR, OWNER
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Name | MR. KHIZER SIKANDER
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Credential |
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Telephone | 734-644-0303
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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 |
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