Hacienda Inc

LBN: Hacienda Inc
Hacienda Inc is an health care organization with primary practice located at 1402 E South Mountain Ave , Phoenix AZ 85042-7925. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. Hacienda Inc can be contacted via phone (602) 243-4231, or through Newport, Barbara via phone (602) 510-3514.

Contact Information

Primary practice address
1402 E South Mountain Ave Phoenix AZ 85042-7925
Phone: (602) 243-4231
Fax: (602) 323-5988
Website:
Map and Directions
Authorized official contact:
Name: Newport, Barbara
Phone: (602) 510-3514

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X LTC0176 Arizona

Profile Details

NPI number 1417178724
LBN Legal business name Hacienda Inc
DBA Doing business as
Authorized official Newport, Barbara
Entity Organization
Organization subpart 1 No
Enumeration date May 2nd, 2007
Last updated Nov 9th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417178724 NPPES
Arizona MEDICAID ICF001
Arizona MEDICAID 040064

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