Organization
SERENITY GROUP HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHADRA S HIRSI (OWNER)
(614) 897-6035
Entity
Organization
Contact information
Practice address
1317 CROWN CT, DE PERE, WI 54115-3815
(614) 897-6035
Mailing address
1317 CROWN CT, DE PERE, WI 54115-3815
(614) 897-6035
(920) 433-6709
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
05/24/2025
Last updated
05/24/2025
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