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NPI Code Detail

MEDICARE: SERENITY PATH LLC

MEDICARE: SERENITY PATH LLC
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1457195695
Entity Type Code : Organization
Provider Name (Legal Business Name) : SERENITY PATH LLC
Provider Business Mailing Address
First Line : 3372 MELWOOD DR
Second Line :
City : MELVINDALE
State : MI
Zip : 48122-1267
Country : US
Telephone Number : 734-210-0599
Fax Number :
Provider Business Practice Location Address
First Line : 22332 GARRISON ST
Second Line :
City : DEARBORN
State : MI
Zip : 48124-2228
Country : US
Telephone Number : 734-210-0599
Fax Number :
Authorized Official
Title or Position : SOCIAL WORKER
Name : KAIFA ALSOOFY
Credential : LMSW
Telephone Number : 734-210-0599
Provider Enumeration Date : 06/22/2024
Last Update Date : 10/11/2025

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Directions to “SERENITY PATH LLC ” Practice Location

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