Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Hacienda Inc

Organization Intellectual Disabilities Intermediate Care Facility · NPI 1417178724

Hacienda Inc is an Intellectual Disabilities Intermediate Care Facility in Phoenix, Arizona. Licensed in Arizona. Registered with an NPI since 2007.

Licensed in
AZ
In the registry since
2007
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1402 E South Mountain Ave
Phoenix, AZ 85042-7925
Phone: (602) 243-4231
Fax: (602) 323-5988
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual Disabilities Intermediate Care Facility (primary) Taxonomy 315P00000X · Licence LTC0176 (AZ)

Record details

NPI number1417178724
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Perry Petrilli — Ceo · (602) 243-4231
NPI enumeratedMay 2, 2007
Last updated in NPPESFebruary 13, 2025
Certification dateFebruary 13, 2025
Mailing address1402 E South Mountain Ave, Phoenix, AZ 85042-7925

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