Hacienda, Inc.

NPI 1417178724 - Intermediate Care Facility, Mentally Retarded - 315P00000X

NPI Details
NPI 1417178724
Enumeration Date 05/02/2007
Last Updated 07/09/2007
Entity Type Healthcare Provider
Active Over 9 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
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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.