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General NPI Number Information
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NPI Number | 1881375053
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Entity Type | Organization
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Legal Business Name | SORRENTO HOMES LLC
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 08/04/2023
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Provider Practice Location Address
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Address Line | 17652 N AVELINO DR
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City | MARICOPA
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State | AZ
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Zip | 85138-4979
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Country | US
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Telephone | 520-316-6070
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Fax |
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Provider Business Mailing Address
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Address Line | 17652 N AVELINO DR
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City | MARICOPA
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State | AZ
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Zip | 85138-4979
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Country | US
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Telephone | 520-316-6070
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DISHON KARIUKI
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Credential |
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Telephone | 678-237-6123
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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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