| NPI Details | |
|---|---|
| NPI | 1417178724 |
| Enumeration Date | 05/02/2007 |
| Last Updated | 07/09/2007 |
| Entity Type | Healthcare Provider |
| Active | Over 10 years ago |
| Authorized Information | |
|---|---|
| Name | DALE NORMAN DALE |
| Position | COO-MS |
| Phone | (602) 243-4231 |
| Fax | (602) 323-5988 |
| Practice Location | |
|---|---|
| 1402 E SOUTH MOUNTAIN AVE PHOENIX AZ, 85042-7925, US |
|
| Phone | (602) 243-4231 |
| Fax | (602) 323-5988 |
| Business Location | |
|---|---|
| 1402 E SOUTH MOUNTAIN AVE PHOENIX AZ, 85042-7925, US |
|
| Phone | (602) 243-4231 |
| Fax | (602) 323-5988 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 315P00000X |
| License State | Arizona |
| License Number | LTC0176 |
| Remove 1417178724 NPI Number | |
According to our database, Hacienda, Inc. NPI is 1417178724, taxonomy code is 315P00000X and license number is LTC0176, license state is located at Arizona. Hacienda, Inc. physically located at 1402 E South Mountain Ave, Phoenix AZ, 85042-7925. NPI Number 1033115704 has the healthcare provider type.
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1417178724 NPI number is provided on an as is basis without warranty of any kind. 1417178724 is maintained by the National Plan & Provider Enumeration System. The contents of Hacienda, Inc. are for informational purposes only.
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