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General NPI Number Information
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NPI Number | 1902551914
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Entity Type | Organization
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Legal Business Name | SERENDIPITY IN THE SUN LLC
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Dates
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Enumeration Date | 02/17/2022
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Last Update Date | 01/31/2023
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Provider Practice Location Address
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Address Line | 6501 E CORRINE DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-4560
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Country | US
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Telephone | 480-761-1778
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Fax | 480-350-7733
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Provider Business Mailing Address
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Address Line | 6501 E CORRINE DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-4560
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Country | US
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Telephone | 480-761-1778
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Fax | 480-350-7733
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Authorized Official
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Title or Position | CLINICAL DIRECTOR/ ALF MANAGER
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Name | DR. RANDY MALLARI
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Credential | OMD, MSN, BSN-RN, BA
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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 | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #2
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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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