CCN: 035258 NPI: 1710976956 Organization

HACIENDA NURSING FACILITY

1402 E SOUTH MOUNTAIN AVE
PHOENIX, AZ 850427925

Contact Information

Phone 6022434231
Fax 6023235988
Enumeration Date 2005-10-20
Last Updated 2020-08-22

Taxonomies

Code: 314000000X (Primary) License State: AZ License: NCI-2617

Inpatient Payment Attributes (IPSF) View Dictionary →

Effective Date:

censusDivision 8

cbsaActualGeographicLocation 38060

providerType 38

vbpAdjustment 1.0

Outpatient Payment Attributes (OPSF) View Dictionary →

Effective Date:

cbsaActualGeographicLocation 38060

providerType 38

operatingCostToChargeRatio 0.001

specialPaymentIndicator

carrierCode 03102

localityCode 00

cbsaActualGeographicLocation 38060

providerType 38

operatingCostToChargeRatio 0.001

specialPaymentIndicator

carrierCode 03102

localityCode 00

cbsaActualGeographicLocation 38060

providerType 38

operatingCostToChargeRatio 0.001

specialPaymentIndicator

carrierCode 03102

localityCode 00