Organization
ST CROIX SERENITY HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMED A MOHAMED (CEO)
(517) 505-0174
Entity
Organization
Contact information
Practice address
519 8TH ST N # B, HUDSON, WI 54016-1140
(517) 505-0174
Mailing address
519 8TH ST N # B, HUDSON, WI 54016-1140
(517) 505-0174
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
06/17/2024
Last updated
06/17/2024
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