SERENITY FACILITY LLC (NPI# 1043622970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043622970 |
| Entity Type | Organization |
| Organization Name | SERENITY FACILITY LLC |
| Practice Address |
18514 Blackmoor St Detroit MI 48234-3887 |
| Mailing Address |
Po Box 479 Saint Clair Shores MI 48080-0479 |
| Practice Telephone | 3138054727 |
| Practice Fax Number | 2488626425 |
| Mailing Telephone | 3138054727 |
| Mailing Fax Number | 2488626425 |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2014-05-27 |
| Authorized Official Name | SONYA SMITH (ADMINISTRATOR) |
| Authorized Official Telephone | 3132050663 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
| N | 320700000X | Residential Treatment Facility, Physical Disabilities | Residential Treatment Facilities | ||
| N | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
| Y | 253Z00000X | In Home Supportive Care | Agencies |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SERENITY FACILITY LLC | 2878 Eddington Ct, Canton, MI 48188-6255 |
| Street Address |
18514 BLACKMOOR ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48234-3887 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205332483 | Bryce Xavier Bredell | Student in an Organized Health Care Education/Training Program | 6071 E Outer Dr, Detroit, MI 48234 | 2018-04-05 |
| 1538668595 | Constance Durden | Social Worker | 19940 Conant Suite B, Detroit, MI 48234 | 2018-02-06 |
| 1891217717 | Donald Williams | Case Manager/Care Coordinator | 19133 Hasse, Detroit, MI 48234 | 2017-07-12 |
| 1063865830 | Gloria A. Love | Psychologist | 19677 Revere, Detroit, MI 48234 | 2016-07-18 |
| 1972977429 | Conant Garden Dental Center Dds PC | Dentist | 2430 E Seven Mile, Suite 6, Detroit, MI 48234 | 2015-11-20 |
| 1861878787 | Kenyatta Philips | Chore Provider | 20119 Helen St, Detroit, MI - MICHIGAN 48234 | 2015-08-03 |
| 1083977144 | Edward Powell | Counselor | 19436 Packard Street, Detroit, MI 48234 | 2012-06-22 |
| 1487931325 | Sonia Renee George | Case Manager/Care Coordinator | 8331 Yolanda St., Detroit, MI 48234 | 2011-11-07 |
| 1851682215 | Detroit Rescue Mission Ministries | Substance Abuse Rehabilitation Facility | 19211 Anglin, Detroit, MI 48234 | 2011-04-20 |
| 1558662742 | Tenille Daniel | Home Health | 17210 Runyon, Detroit, MI 48234 | 2010-11-04 |
| Find all providers in zip 48234 | ||||
| Taxonomy Code | 253Z00000X |
| Grouping | Agencies |
| Classification | In Home Supportive Care |
| An In Home Supportive Care Agency provides services in the patient’s home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588285001 | Kadeidra Woods | In Home Supportive Care | 18709 Albion St, Detroit, MI 48234-3701 | 2020-05-06 |
| 1497375547 | Continuum Loving Care, LLC | In Home Supportive Care | 16724 Saint Marys St, Detroit, MI 48235-3653 | 2020-04-19 |
| 1225670656 | Veronica Louise Williams | In Home Supportive Care | 7601 E Jefferson Ave Apt 512, Detroit, MI 48214-3720 | 2019-10-17 |
| 1386298438 | Jewels Home Health Care Service, LLC | In Home Supportive Care | 14005 Roselawn St, Detroit, MI 48238-2469 | 2019-07-27 |
| 1154974541 | Tracie's Loving Touch Senior Services LLC | In Home Supportive Care | 18273 Lenore, Detroit, MI 48219-3046 | 2019-07-24 |
| 1477105369 | Cam Fam Community Care LLC | In Home Supportive Care | 16718 Vaughan St, Detroit, MI 48219-3356 | 2019-07-11 |
| 1326500547 | Averies Care Services LLC | In Home Supportive Care | 18717 Schaefer Hwy, Detroit, MI 48235-1767 | 2019-04-05 |
| 1962985598 | Delanie House LLC | In Home Supportive Care | 9530 Chatham, Detroit, MI 48239-1306 | 2018-09-10 |
| 1427536226 | Imperial Jewelry By Ellice, Inc | In Home Supportive Care | 13704 Keal St # 101, Detroit, MI 48227-3019 | 2018-08-02 |
| 1134605363 | Phoenix Wings | In Home Supportive Care | 2222 Lothrop St, Detroit, MI 48206-2672 | 2018-07-11 |
| Find all providers in DETROIT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.