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HACIENDA SKILLED NURSING FACILITY

Nursing Care, Pediatric

Phoenix, Arizona

Provider NPI: 1831322676

Organization Information:
Organization Name:  HACIENDA SKILLED NURSING FACILITY


Practice Location:
1402 E SOUTH MOUNTAIN AVE  PHOENIX, AZ 85042 US
Tel: 602-243-4231  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N3140N1450XNursing & Custodial Care Facilities
Skilled Nursing Facility
Nursing Care, Pediatric
AZLTC 0195
Y343900000XTransportation Services
Non-emergency Medical Transport (VAN)
AZLTC 0195

Other Provider Identifiers:

IssuerNumberStateType
STATE LICENSELTC 0195AZ01
CLIA03D1096517AZ01
544032AZ05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




PEDIATRIC NURSING JOBS AZ - Page 1



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