Organization Active NPI

Serenity Home Hospice LLC

  • Community Based Hospice Care Agency
  • Dearborn, MI
National Provider Identifier
1649904830
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
SERENITY HOME HOSPICE LLC
Practice address
1711 Monroe St
Dearborn, MI 48124-2914
Phone
(313) 562-9100
NPI assigned
Jul 13, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Khalid ZakariaNPI 1033101084
Title
Owner
Phone
(313) 562-9100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

1711 Monroe St
Dearborn, MI 48124-2914

Mailing address

1391 E 12 Mile Rd
Madison Heights, MI 48071-2914
Phone (313) 551-5025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230516002074 MI Part A Provider - Hospice 4981060001 Practice locations: Dearborn, MI

Hospice certification: CCN 231716

Legal name
SERENITY HOME HOSPICE LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jan 20, 2024
Last certification
Dec 22, 2023
Organization structure
LLCProprietary
Incorporated
Jun 30, 2022 in MI
Enrollment address
1711 Monroe St
Dearborn, MI 48124-2914

Care Compare: Hospice

Medicare Care Compare
Listed as
Serenity Home Hospice, LLCCCN 231716 · All quality measures
Certified
Jan 20, 2024
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2280921Serenity Hospice1711 Monroe, Dearborn, MI 48124Certificate of waiverApr 27, 2027

National Provider Directory

National Provider Directory

Locations

1391 E 12 Mile Rd
Madison Heights, MI 48071

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Khalid Sabah Zakaria Individual 5% Or Greater Direct Ownership InterestPresident Jun 30, 2022 100%
Corporate DirectorPresident Jun 30, 2022 100%
Operational/Managerial ControlPresident Jun 30, 2022 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751241600000",
    "number": "1649904830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1391 E 12 MILE RD",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480712914",
            "telephone_number": "313-551-5025",
            "fax_number": "313-451-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 MONROE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242914",
            "telephone_number": "313-562-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY HOME HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-13",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "ZAKARIA",
        "authorized_official_first_name": "KHALID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-562-9100"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.