HACIENDA SKILLED NURSING FACILITY, INC.
NPI 1710976956
Skilled Nursing Facility in Phoenix, AZ

Active since October 20, 2005
1402 E SOUTH MOUNTAIN AVE, PHOENIX, AZ 85042(602) 243-4231(602) 323-5988 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Hacienda Skilled Nursing Facility, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HACIENDA SKILLED NURSING FACILITY, INC. (NPI 1710976956), doing business as Hacienda, Inc., is a healthcare organization registered as a skilled nursing facility in Phoenix, Arizona and active in the NPI registry since October 2005. The organization lists Dale Norman Skurdahl, Chief Operating Officer - Med Serv., as its authorized official.

NPPES Registry Identity

NPI1710976956
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameHACIENDA SKILLED NURSING FACILITY, INC.
Location Address1402 E SOUTH MOUNTAIN AVEPhoenix, AZ 85042-7925
Mailing Address1402 E South Mountain AvePhoenix, AZ 85042-7925 · (602) 243-4231 · Fax (602) 323-5988
Fax(602) 323-5988
Organization SubpartNo
Authorized OfficialDale Norman SkurdahlChief Operating Officer - Med Serv. · (602) 243-4231
Enumeration DateOctober 20, 2005
Last NPPES UpdateAugust 22, 2020
NPI 1710976956 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in AZ · NCI-2617
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
1402 E SOUTH MOUNTAIN AVE, Phoenix, AZ 85042

Other Names 1

Former Legal Business NameHacienda, Inc.

Other Identifiers 1

Medicaid544032AZ

Accepted Insurance

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Occupational Therapist
1402 E SOUTH MOUNTAIN AVE, REHAB DEPT
PHOENIX, AZ 85042
Intermediate Care Facility, Intellectual Disabilities
1402 E SOUTH MOUNTAIN AVE
PHOENIX, AZ 85042
Physical Therapist
1402 E SOUTH MOUNTAIN AVE
PHOENIX, AZ 85042
Non-emergency Medical Transport (VAN)
1402 E SOUTH MOUNTAIN AVE
PHOENIX, AZ 85042
Occupational Therapist
1402 E SOUTH MOUNTAIN AVE
PHOENIX, AZ 85042
Occupational Therapist
1402 E SOUTH MOUNTAIN AVE
PHOENIX, AZ 85042
Durable Medical Equipment & Medical Supplies (Oxygen Equipment & Supplies)
1402 E SOUTH MOUNTAIN AVE
PHOENIX, AZ 85042
Non-emergency Medical Transport (VAN)
1402 E SOUTH MOUNTAIN AVE
PHOENIX, AZ 85042

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Hacienda Skilled Nursing Facility, Inc.'s NPI number?

The NPI number for Hacienda Skilled Nursing Facility, Inc. is 1710976956. It was assigned to this organization in the NPPES registry on October 20, 2005. The provider was formerly known as Hacienda, Inc..

Where is Hacienda Skilled Nursing Facility, Inc. located?

Hacienda Skilled Nursing Facility, Inc. is located at 1402 E South Mountain Ave, Phoenix, AZ 85042. The listed phone number is (602) 243-4231.

What is Hacienda Skilled Nursing Facility, Inc.'s specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

What insurance does Hacienda Skilled Nursing Facility, Inc. accept?

Health plans from Ambetter from Arizona Complete Health list Hacienda Skilled Nursing Facility, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Hacienda Skilled Nursing Facility, Inc. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.