Hacienda C H Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

940000084 Issued in CA

Legal business name

HACIENDA C H INC

Practice address

2725 E Broadway
Long Beach, CA 90803-5431

Phone

(562) 434-4494

NPI assigned

Dec 7, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marc Johnson

Title

Cfo

Phone

(949) 373-8373

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• BROADWAY BY THE SEA Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712275200000",
    "number": "1922083435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25910 ACERO STE 350",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926917908",
            "telephone_number": "949-441-9258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 E BROADWAY",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908035431",
            "telephone_number": "562-434-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HACIENDA C H INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-07",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "949-373-8373"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "940000084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05894I",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BROADWAY BY THE SEA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BROADWAY BY THE SEA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cecilia Habacon, LCSW
• Edna Habig
• Hablemos Hoy Therapy a Licensed
• Brigette Garcia Hacia
• Megan Elizabeth Hacia, DPT
• Hacienda Grande
• Hacienda Grande Senior Assisted Living
• Jodie Lee Hackett
• Sarah Hackett
• Natalie R Haddad

• Skilled Nursing Facility in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.