institution
Hacienda Skilled Nursing Facility
Non-emergency Medical Transport (VAN) in Phoenix, Arizona
NPI 1831322676

Hacienda Skilled Nursing Facility is a Non-emergency Medical Transport (VAN) based in Phoenix, AZ. Hacienda Skilled Nursing Facility practices in Phoenix, AZ. The NPI Number for Hacienda Skilled Nursing Facility is 1831322676 and holds a License No. LTC 0195 (Arizona).

The current practice location address for Hacienda Skilled Nursing Facility 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. You can also correspond with Hacienda Skilled Nursing Facility through the mailing address at 1402 E SOUTH MOUNTAIN AVE, PHOENIX, AZ - 85042-7925 (mailing address contact number: 602-243-4231).

Location: 1402 E South Mountain Ave, Phoenix, AZ, 85042-7925
institution
Provider Profile Details
NPI Number
1831322676
Provider Name
Hacienda Skilled Nursing Facility
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
08/27/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
544032 05 AZ
LTC 0195 01 AZ STATE LICENSE
03D1096517 01 AZ CLIA
institution
Provider Business Practice Location Address Details
Address
1402 E South Mountain Ave
City
State
Zip
85042-7925
Phone Number
602-243-4231
Fax Number
602-323-5988
person
Provider Business Mailing Address Details
Address
1402 E South Mountain Ave
City
State
Zip
85042-7925
Phone Number
602-243-4231
Fax Number
602-323-5988
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Skilled Nursing Facility
Speciality
Nursing Care, Pediatric
Taxonomy
License No.
LTC 0195 (Arizona)
Definition
A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment.
person
Provider's Taxonomy Details 2
Type
Transportation Services
Classification
Non-emergency Medical Transport (VAN)
Speciality
-
Taxonomy
License No.
LTC 0195 (Arizona)
Definition
A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations.
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