NPI 1417178724

Hacienda INC

Organisation Intellectual Disabilities Intermediate Care Facility Phoenix, AZ

Practice location

Address: 1402 E South Mountain Ave, Phoenix, AZ 85042-7925
Phone: (602) 243-4231
Fax: (602) 323-5988

Authorised official

Name: Perry Petrilli
Title: Ceo
Phone: (602) 243-4231

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence LTC0176 (AZ)

Other Intermediate Care Facility, Intellectual Disabilities providers in Arizona →

Registry record

NPI: 1417178724
Entity type: Organization
NPI issued: 2 May 2007
Record last updated: 13 Feb 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.