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General NPI Number Information
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NPI Number | 1437302056
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Entity Type | Organization
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Legal Business Name | SERENITY HOME CARE SERVICES, P.C.
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Dates
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Enumeration Date | 10/28/2008
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Last Update Date | 06/18/2010
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Provider Practice Location Address
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Address Line | 17800 WOODWARD AVENUE SUITE 100 C
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City | DETROIT
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State | MI
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Zip | 48203-2259
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Country | US
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Telephone | 313-865-0598
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Fax | 313-865-4723
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Provider Business Mailing Address
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Address Line | 17800 WOODWARD AVENUE SUITE 100 C
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City | DETROIT
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State | MI
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Zip | 48203-2259
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Country | US
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Telephone | 313-865-0598
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Fax | 313-865-4723
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JOHN EMEKA AZUBOGU
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Credential |
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Telephone | 313-865-0598
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | MI
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