Organization
SERENITY RESIDENTIAL HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CALVIN JACKSON JR. (CEO)
(313) 587-5247
Entity
Organization
Contact information
Practice address
13974 LAUDER ST, DETROIT, MI 48227-2559
(313) 587-5247
Mailing address
29155 NORTHWESTERN HWY # 400, SOUTHFIELD, MI 48034-1011
(313) 587-5247
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253J00000X
Foster Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
Other
Enumeration date
09/20/2024
Last updated
09/20/2024
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