HACIENDA INC NPI 1841513413

NPI Information

NPI: 1841513413
Provider Name: HACIENDA INC

Doing Business As: HACIENDA HCBS

Classification: Intermediate Care Facility, Mentally Retarded - 315P00000X
Entity Type: Organization
Address:
1402 E SOUTH MOUNTAIN AVE
PHOENIX, AZ
ZIP 85042
Phone: (602) 243-4231
Get Directions

HACIENDA INC is an intermediate care facility mentally retarded in Phoenix, AZ. The provider is (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. HACIENDA INC NPI is 1841513413. The provider is registered as an organization entity type.
The provider Is Doing Business As Hacienda Hcbs.

The provider's business location address is:

1402 E SOUTH MOUNTAIN AVE
PHOENIX, AZ
ZIP 85042-925
Phone: (602) 243-4231
Fax: (602) 323-5988

The provider's authorized official is Barbara Newport .
The authorized official title is Credentialing And Licensing Manager and has the following contact phone number (602) 243-4231.

The enumeration date for this NPI number is 3/10/2010 and was last updated on 11/9/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	311Z00000X	Custodial Care Facility		DDH1558	ARIZONA	No
2	315P00000X	Intermediate Care Facility, Mentally Retarded				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	075368	MEDICAID	ARIZONA
2	040064	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »