# LA HACIENDA SCC LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** La Hacienda Nursing & Rehab Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851799167
- **Authorized official:** MICHAEL BEAL (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (214) 252-7600

## Contact information

- **Practice address:** 3730 W OREM DR, HOUSTON, TX 77045-4426
- **Practice address phone:** (832) 799-6484
- **Practice address fax:** (832) 201-6952
- **Mailing address:** 600 N PEARL ST STE 1050, DALLAS, TX 75201-7495
- **Mailing address phone:** (214) 252-7600
- **Mailing address fax:** (214) 252-7704

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | TX | Yes |

## Other

- **Enumeration date:** 12/18/2014
- **Last updated:** 03/03/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001026540 | — | TX |
| 01 | — | 5625 105089 | VENDOR ID/FACILITY ID | TX |