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Organization
SERENITY FACILITY LLC
Active
Organization
SERENITY FACILITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SONYA SMITH (ADMINISTRATOR)
(313) 205-0663
Entity
Organization
Contact information
Practice address
18514 BLACKMOOR ST, DETROIT, MI 48234-3887
(313) 805-4727
(248) 862-6425
Mailing address
PO BOX 479, SAINT CLAIR SHORES, MI 48080-0479
(313) 805-4727
(248) 862-6425
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
NULL
320700000X
Physical Disabilities Residential Treatment Facility
—
NULL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
NULL
Other
Enumeration date
05/27/2014
Last updated
05/27/2014
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