Provider Demographics
NPI:1275824492
Name:SERENITY AT HOME, LLC
Entity Type:Organization
Organization Name:SERENITY AT HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TYRONE
Authorized Official - Middle Name:H
Authorized Official - Last Name:RASHID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-912-1030
Mailing Address - Street 1:28345 BECK RD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:WIXOM
Mailing Address - State:MI
Mailing Address - Zip Code:48393-4733
Mailing Address - Country:US
Mailing Address - Phone:248-912-1030
Mailing Address - Fax:248-912-1031
Practice Address - Street 1:28345 BECK RD
Practice Address - Street 2:SUITE 209
Practice Address - City:WIXOM
Practice Address - State:MI
Practice Address - Zip Code:48393-4733
Practice Address - Country:US
Practice Address - Phone:248-912-1030
Practice Address - Fax:248-912-1031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based