| NPI | 1841513413 |
|---|---|
| Doing Business As | HACIENDA HCBS |
| Entity Type | Organization |
| Authorized Contact | BARBARA NEWPORT Credentialing And Licensing Manager 602-243-4231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Additional Taxonomies | 311Z00000X Custodial Care Facility (Licence: AZ DDH1558) |
| Enumeration Date | 2010-03-10 |
| Last Update Date | 2020-11-09 |