Provider Demographics
NPI:1225310766
Name:SERENITY HOME HEALTH CARE SERVICES LLC
Entity Type:Organization
Organization Name:SERENITY HOME HEALTH CARE SERVICES LLC
Other - Org Name:SERENITY HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:GABRIELL
Authorized Official - Middle Name:
Authorized Official - Last Name:MALOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-633-3555
Mailing Address - Street 1:26280 HUNTINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-3439
Mailing Address - Country:US
Mailing Address - Phone:313-633-3555
Mailing Address - Fax:586-776-7915
Practice Address - Street 1:26280 HUNTINGTON ST
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-3439
Practice Address - Country:US
Practice Address - Phone:313-633-3555
Practice Address - Fax:586-776-7915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-11
Last Update Date:2011-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health