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General NPI Number Information
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NPI Number | 1679572929
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Entity Type | Organization
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Legal Business Name | HACIENDA POST ACUTE, INC.
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 09/05/2019
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Provider Practice Location Address
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Address Line | 361 E GRANGEVILLE BLVD
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City | HANFORD
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State | CA
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Zip | 93230-3054
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Country | US
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Telephone | 559-582-9221
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Fax | 559-582-8955
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Provider Business Mailing Address
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Address Line | 1440 S STATE COLLEGE BLVD SUITE 2A
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City | ANAHEIM
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State | CA
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Zip | 92806-5724
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Country | US
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Telephone | 714-778-0221
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Fax | 714-778-0574
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MRS. DONNA F STOTTS
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Credential |
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Telephone | 714-778-0221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 040000101
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License Number State | CA
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