HACIENDA SKILLED NURSING FACILITY, INC.
Nursing at South Mountain Ave, Phoenix, AZ

License number
Arizona NCI-2617
Category
Nursing
Type
Skilled Nursing Facility
Owner
Name: MR. DALE NORMAN SKURDAHL MA IN EDUCATION
Title: CHIEF OPERATING OFFICER - MED SERV.
Phone: (602) 243-4231
Address
Address
1402 SOUTH South Mountain Ave, Phoenix, AZ 85042
National Provider ID: 1710976956
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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HACIENDA SKILLED NURSING FACILITY, INC

1402 E South Mtn Ave, Phoenix, AZ 85042

Industry:
Skilled Nursing Care Facility
Registration:
Feb 19, 2004
State ID:
-1118542-9
Expiration:
PERPETUAL
Chief Executive Officers:
Tom Pomeroy (Other officer), 65 Biltmore Est, Phoenix, AZ 85016 (Physical),Dick Kaupie (President), 16714 N 50 Way, Scottsdale, AZ 85254 (Physical),Ralph Wallork (Treasurer), 9004 E Pershing Ave, Scottsdale, AZ 85260 (Physical),...
Agent:
National Registered Agents Inc,2390 E Camelback Rd, Phoenix, AZ 85016 (Physical)

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