Hacienda, Inc.

LBN: Hacienda Skilled Nursing Facility, 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 / Skilled Nursing Facility, which is considered as the primary health care specialty. Hacienda Skilled Nursing Facility, Inc. 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 MA IN EDUCATION
Phone: (602) 243-4231

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X NCI-2617 Arizona

Profile Details

NPI number 1710976956
LBN Legal business name Hacienda Skilled Nursing Facility, Inc.
DBA Doing business as Hacienda, Inc.
Authorized official Skurdahl, Dale Norman MA IN EDUCATION
Entity Organization
Organization subpart 1 No
Enumeration date Oct 20th, 2005
Last updated Aug 22nd, 2020 - about 5 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 1710976956 NPPES
Arizona MEDICAID 544032

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