Hacienda Snf Transport

LBN: Hacienda Skilled Nursing Facility
Hacienda Snf Transport is an health care organization with primary practice located at 1402 E South Mountain Ave , Phoenix AZ 85042-7925. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Nursing Care, Pediatric, Transportation Services / Non-emergency Medical Transport (VAN). Transportation Services / Non-emergency Medical Transport (VAN) is the primary health care specialty. Hacienda Skilled Nursing Facility can be contacted via phone (602) 243-4231, or through Skurdahl, Dale Norman via phone (602) 243-4231.

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: Skurdahl, Dale Norman
Phone: (602) 243-4231

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Nursing Care, Pediatric 3140N1450X LTC 0195 Arizona
Transportation Services / Non-emergency Medical Transport (VAN) 343900000X LTC 0195 Arizona

Profile Details

NPI number 1831322676
LBN Legal business name Hacienda Skilled Nursing Facility
DBA Doing business as Hacienda Snf Transport
Authorized official Skurdahl, Dale Norman
Entity Organization
Organization subpart 1 No
Enumeration date Aug 27th, 2009
Last updated Aug 27th, 2009 - about 15 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 1831322676 NPPES
Arizona MEDICAID 544032
Arizona Other LTC 0195
Arizona Other 03D1096517

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