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General NPI Number Information
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NPI Number | 1124724398
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Entity Type | Organization
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Legal Business Name | SERENDIPITY IN THE SUN II LLC
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Dates
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Enumeration Date | 01/31/2023
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Last Update Date | 01/31/2023
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Provider Practice Location Address
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Address Line | 10250 N 124TH ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-5201
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Country | US
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Telephone | 602-859-3256
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Fax |
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Provider Business Mailing Address
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Address Line | 10250 N 124TH ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-5201
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ALF MANAGER/ ADMINISTRATOR
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Name | RANDY MALLARI
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Credential | MSN, RN, CNL, CHC
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Telephone | 602-908-8580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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