Provider Demographics
NPI:1417323098
Name:SERENITY HOSPICE OF MICHIGAN
Entity Type:Organization
Organization Name:SERENITY HOSPICE OF MICHIGAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR, OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KHIZER
Authorized Official - Middle Name:
Authorized Official - Last Name:SIKANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-644-0303
Mailing Address - Street 1:5366 W ROLLING HILLS DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:MI
Mailing Address - Zip Code:48722-9671
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6942 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:MI
Practice Address - Zip Code:48722-9760
Practice Address - Country:US
Practice Address - Phone:734-644-0303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based