| Serenity Path Llc | |
|
39293 Plymouth Rd Ste 118i Livonia MI 48150-1060 | |
| (734) 210-0599 | |
| Not Available |
| Full Name | Serenity Path Llc |
|---|---|
| Speciality | Social Worker |
| Location | 39293 Plymouth Rd Ste 118i, Livonia, Michigan |
| Authorized Official Name and Position | Kaifa Alsoofy (SOCIAL WORKER) |
| Authorized Official Contact | 7342100599 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Serenity Path Llc 3372 Melwood Dr Melvindale MI 48122-1267 Ph: (734) 210-0599 | Serenity Path Llc 39293 Plymouth Rd Ste 118i Livonia MI 48150-1060 Ph: (734) 210-0599 |
| NPI Number | 1457195695 |
|---|---|
| Provider Enumeration Date | 06/22/2024 |
| Last Update Date | 08/21/2024 |
| Certification Date | 08/21/2024 |
| Medicare PECOS PAC ID | 3779023551 |
|---|---|
| Medicare Enrollment ID | O20240906003537 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457195695 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kaifa Alsoofy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811378672 PECOS PAC ID: 1254733199 Enrollment ID: I20210714001939 |
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