Servants Heart Mobile Medical Clinic

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

SERVANTS HEART MOBILE MEDICAL CLINIC

Practice address

15012 Penrod St
Detroit, MI 48223-2337

Phone

(623) 277-7828

NPI assigned

Oct 21, 2024

Organization subpart

No

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

Authorized official

Name

Paula Lorraine Hester

Title

Ceo/Healthcare Director

Phone

(623) 277-7828

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1669293874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25552 SHIAWASSEE RD APT 521",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333708",
            "telephone_number": "623-277-7828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15012 PENROD ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482232337",
            "telephone_number": "623-277-7828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERVANTS HEART MOBILE MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-21",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "HESTER",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "LORRAINE",
        "authorized_official_title_or_position": "CEO/HEALTHCARE DIRECTOR",
        "authorized_official_telephone_number": "623-277-7828"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ricardo Benjamin Serrano, M.D.
• Esteffania Serrato Cornejo
• Sertainley S Home Care Limited Liability Company
• Sertainley'S Home Care LLC
• Servant Heart Keepers Adult Living
• Services to Enhance Potential
• Serving Hearts Group Homes II, LLC
• Malgorzata Serwatka, PT, DPT, CI
• Shivaprakash Seshadri, MD
• Jenna Sesi

• Medical Specialty Clinic/Center in Detroit, MI
• Providers in Detroit, MI by specialty
• Medical Specialty Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.