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NPI 1548019375

NPI 1548019375 : SERENITY STEP LLC : DEARBORN, MI

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General NPI Number Information
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    NPI Number           |    1548019375
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    Entity Type          |    Organization 
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    Legal Business Name  |    SERENITY STEP LLC 
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Dates
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    Enumeration Date     |    05/14/2024
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    Last Update Date     |    10/29/2025
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Provider Practice Location Address
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    Address Line         |    4 PARKLANE BLVD STE 350 
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    City                 |    DEARBORN
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    State                |    MI
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    Zip                  |    48126-4216
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    Country              |    US
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    Telephone            |    313-652-5313
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4 PARKLANE BLVD STE 350 
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    City                 |    DEARBORN
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    State                |    MI
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    Zip                  |    48126-4216
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    Country              |    US
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    Telephone            |    313-652-5313
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    Fax                  |    
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Authorized Official
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    Title or Position    |    FOUNDER
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    Name                 |     DIANA  BAZZI 
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    Credential           |    
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    Telephone            |    313-652-5313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251B00000X
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    Taxonomy Name        |    Case Management Agency
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    261QR0405X
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    Taxonomy Name        |    Substance Use Disorder Rehabilitation Clinic/Center
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    251S00000X
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    Taxonomy Name        |    Community/Behavioral Health Agency
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    License Number       |    
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    License Number State |    
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