Provider Demographics
NPI:1942834791
Name:FAIN SERENITY CARE, LLC
Entity Type:Organization
Organization Name:FAIN SERENITY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:FAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-895-4324
Mailing Address - Street 1:2705 62ND ST W
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33971-5849
Mailing Address - Country:US
Mailing Address - Phone:239-895-4324
Mailing Address - Fax:
Practice Address - Street 1:2705 62ND ST W
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-5849
Practice Address - Country:US
Practice Address - Phone:239-895-4324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-02
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty