HACIENDA INC
NPI 1841513413
Intermediate Care Facility, Intellectual Disabilities in Phoenix, AZ
- Organization
- Intermediate Care Facility, Intellectual...
About HACIENDA INC
This page provides the complete NPI Profile along with additional information for Hacienda Inc, a provider established in Phoenix, Arizona operating as a Intermediate Care Facility, Intellectual Disabilities. The healthcare provider is registered in the NPI registry with number 1841513413 assigned on March 2010. The practitioner's primary taxonomy code is 315P00000X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Perry Petrilli (Ceo)
- NPI
- 1841513413 Verify this NPI
- Provider Name
- HACIENDA INC
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 1402 E SOUTH MOUNTAIN AVE PHOENIX, AZ 85042
- Location Phone
- (602) 243-4231
- Location Fax
- (602) 323-5988
- Mailing Address
- 1402 E SOUTH MOUNTAIN AVE PHOENIX, AZ 85042
- Mailing Phone
- (602) 243-4231
- Mailing Fax
- (602) 323-5988
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-10-2010
- Last Update Date
- 02-13-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Intermediate Care Facility, Intellectual Disabilities
- Taxonomy Code
- 315P00000X
- Type
- Nursing & Custodial Care Facilities
- Taxonomy Description
- An intermediate care facility providing services for individuals with intellectual disabilities.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 311Z00000X | Nursing & Custodial Care Facilities | Custodial Care Facility | DDH1558 (AZ) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 040064 | MEDICAID (05) | AZ | |
| 075368 | MEDICAID (05) | AZ |
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Other Providers at the Same Location
The following 10 providers are registered at the same or a nearby location.
PHOENIX, AZ 85042
PHOENIX, AZ 85042
PHOENIX, AZ 85042
PHOENIX, AZ 85042
PHOENIX, AZ 85042
PHOENIX, AZ 85042
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1841513413, enumerated as an "organization" on March 10, 2010.
The provider is located at 1402 E SOUTH MOUNTAIN AVE PHOENIX, AZ 85042 and the phone number is (602) 243-4231.
Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
