MEDICARE: SERENITY SPRINGS RESIDENTIAL CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1164366688
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITY SPRINGS RESIDENTIAL CARE

Provider Business Mailing Address
First Line	:	30150 PALMER BLVD
Second Line	:
City	:	MADISON HTS
State	:	MI
Zip	:	48071-1826
Country	:	US
Telephone Number	:	313-500-8603
Fax Number	:

Provider Business Practice Location Address
First Line	:	30150 PALMER BLVD
Second Line	:
City	:	MADISON HTS
State	:	MI
Zip	:	48071-1826
Country	:	US
Telephone Number	:	313-500-8603
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHERRIA PERRY
Credential	:
Telephone Number	:	313-500-8603

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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