Hacienda Inc
Hacienda Inc is a Custodial Care Facility in Phoenix, Arizona. Licensed in Arizona. Registered with an NPI since 2010.
- Licensed in
- AZ
- In the registry since
- 2010
- Specialties on file
- 2
What do these letters mean?
- Inc — Incorporated
- A form of business registration, not a clinical qualification.
Practice location Address checks out
1402 E South Mountain AvePhoenix, AZ 85042-7925
Phone: (602) 243-4231
Fax: (602) 323-5988
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Intellectual Disabilities Intermediate Care Facility (primary) | Taxonomy 315P00000X |
|---|---|
| Custodial Care Facility | Taxonomy 311Z00000X · Licence DDH1558 (AZ) |
Record details
| NPI number | 1841513413 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Perry Petrilli — Ceo · (602) 243-4231 |
| Other names | Hacienda Hcbs; Hacienda Hcbs |
| NPI enumerated | March 10, 2010 |
| Last updated in NPPES | February 13, 2025 |
| Certification date | February 13, 2025 |
| Mailing address | 1402 E South Mountain Ave, Phoenix, AZ 85042-7925 |
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