Provider Demographics
NPI:1598746893
Name:SERENITY HOME HEALTH, INC.
Entity Type:Organization
Organization Name:SERENITY HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ADEMOLA
Authorized Official - Middle Name:OLUSEGUN
Authorized Official - Last Name:OSOFISAN
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:734-677-0766
Mailing Address - Street 1:3460 E ELLSWORTH RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-2049
Mailing Address - Country:US
Mailing Address - Phone:734-677-0766
Mailing Address - Fax:734-677-3151
Practice Address - Street 1:3460 E ELLSWORTH RD
Practice Address - Street 2:SUITE 201
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-2049
Practice Address - Country:US
Practice Address - Phone:734-677-0766
Practice Address - Fax:734-677-3151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237574Medicare ID - Type UnspecifiedPROVIDER NUMBER