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HACIENDA INC
NPI 1841513413
Intermediate Care Facility, Intellectual Disabilities in Phoenix, AZ

Active since March 10, 2010
1402 E SOUTH MOUNTAIN AVE, PHOENIX, AZ 85042(602) 243-4231(602) 323-5988 Get Directions Write a Review

NPPES record last updated: February 13, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 13, 2025, Nov 9, 2020, Jul 15, 2020 (3 updates tracked since 2020).

About Hacienda Inc NPPES

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

HACIENDA INC (NPI 1841513413), doing business as Hacienda Hcbs, is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Phoenix, Arizona and active in the NPI registry since March 2010. The organization lists Perry Petrilli, Ceo, as its authorized official.

NPPES Registry Identity

NPI1841513413
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameHACIENDA 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
Phone(602) 243-4231
Fax(602) 323-5988
Organization SubpartNo
Authorized OfficialPerry PetrilliCeo · (602) 243-4231
Enumeration DateMarch 10, 2010
Last NPPES UpdateFebruary 13, 20253 updates tracked since enumeration
NPPES CertifiedFebruary 13, 2025
✔ NPI 1841513413 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
Also ListedCustodial Care FacilityTaxonomy 311Z00000X · License DDH1558 (AZ)
1402 E SOUTH MOUNTAIN AVE, Phoenix, AZ 85042
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Other Names 1

Doing Business AsHacienda Hcbs

Other Identifiers 2

Medicaid040064AZ
Medicaid075368AZ

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.

VIVIANA MONTALVAN OTR/L
Occupational Therapist
1402 E SOUTH MOUNTAIN AVE, REHAB DEPT
PHOENIX, AZ 85042
Maricopa County (602) 243-4231
HACIENDA INC
Intermediate Care Facility, Intellectual Disabilities
1402 E SOUTH MOUNTAIN AVE
PHOENIX, AZ 85042
Maricopa County (602) 243-4231
MS. MIRIAM ALFARO P.T.
Physical Therapist
1402 E SOUTH MOUNTAIN AVE
PHOENIX, AZ 85042
Maricopa County (602) 243-4231
LOS NINOS HOSPITAL, INC
Non-emergency Medical Transport (VAN)
1402 E SOUTH MOUNTAIN AVE
PHOENIX, AZ 85042
Maricopa County (602) 243-4231
MS. EMILY MILLER OTR/L
Occupational Therapist
1402 E SOUTH MOUNTAIN AVE
PHOENIX, AZ 85042
Maricopa County (602) 243-4231
MRS. MARRENE WHITE PEACHER OTR
Occupational Therapist
1402 E SOUTH MOUNTAIN AVE
PHOENIX, AZ 85042
Maricopa County (480) 239-0224
LOS NINOS HOSPITAL INC
Durable Medical Equipment & Medical Supplies (Oxygen Equipment & Supplies)
1402 E SOUTH MOUNTAIN AVE
PHOENIX, AZ 85042
Maricopa County (602) 424-9880
HACIENDA SKILLED NURSING FACILITY, INC.
Skilled Nursing Facility
1402 E SOUTH MOUNTAIN AVE
PHOENIX, AZ 85042
Maricopa County (602) 243-4231

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 Inc's NPI number?

The NPI number for Hacienda Inc is 1841513413. It was assigned to this organization in the NPPES registry on March 10, 2010. The provider is doing business as Hacienda HCBS.

Where is Hacienda Inc located?

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

What is Hacienda Inc's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for Hacienda Inc was last updated on February 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.