Provider Demographics
NPI:1962215731
Name:RECLAIM SERENITY SENIOR LIVING LLC
Entity type:Organization
Organization Name:RECLAIM SERENITY SENIOR LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PHYLLENCIA
Authorized Official - Middle Name:GEREA
Authorized Official - Last Name:MCCASKILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-234-1063
Mailing Address - Street 1:20415 ERIN ST # 148
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-4535
Mailing Address - Country:US
Mailing Address - Phone:248-234-1063
Mailing Address - Fax:
Practice Address - Street 1:20415 ERIN ST # 148
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-4535
Practice Address - Country:US
Practice Address - Phone:248-234-1063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care