Provider Demographics
NPI:1003788316
Name:SERENITY 2 LLC
Entity type:Organization
Organization Name:SERENITY 2 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SHIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:KOPERSHTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-586-9756
Mailing Address - Street 1:149 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-3613
Mailing Address - Country:US
Mailing Address - Phone:917-586-9756
Mailing Address - Fax:863-658-1176
Practice Address - Street 1:149 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-3613
Practice Address - Country:US
Practice Address - Phone:917-586-9756
Practice Address - Fax:863-658-1176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness