Hacienda Inc - Phoenix, AZ

Hacienda Inc

Intellectual Disabilities Intermediate Care Facility in Phoenix, Arizona

NPI 1417178724

Hacienda Inc is a Intellectual Disabilities Intermediate Care Facility based in Phoenix, AZ. Hacienda Inc practices in Phoenix, AZ. The NPI Number for Hacienda Inc is 1417178724 and holds a License No. LTC0176 (Arizona).

The current practice location address for Hacienda Inc is 1402 E South Mountain Ave, Phoenix, AZ and can be reached out via phone at 602-243-4231 and via fax at 602-323-5988.

Location: 1402 E South Mountain Ave, Phoenix, AZ, 85042-7925

NPI Number

1417178724

Provider Name

Hacienda Inc

Credential

Provider Entity Type

Organization

Address

1402 E South Mountain Ave, Phoenix, AZ, 85042-7925

Phone Number

602-243-4231

Fax Number

602-323-5988

Provider Enumeration Date

05/02/2007

Last Update Date

03/09/2024

Identifier	Type	State	Issuer
ICF001	05	AZ
040064	05	AZ

Address

1402 E South Mountain Ave

City

Phoenix

State

Arizona

Zip

85042-7925

Phone Number

602-243-4231

Fax Number

602-323-5988

Address

1402 E South Mountain Ave

City

Phoenix

State

Arizona

Zip

85042-7925

Phone Number

602-243-4231

Fax Number

602-323-5988

Type

Nursing & Custodial Care Facilities

Classification

Intermediate Care Facility, Mentally Retarded

Speciality

Taxonomy

315P00000X

License No.

LTC0176 (Arizona)

Definition

(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.

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