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Organization
LA PALOMA FAMILY SERVICES
Active
Organization
LA PALOMA FAMILY SERVICES
Active
Other names
Fairview LII Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID BRADLEY (CEO)
(520) 750-9667
Entity
Organization
Contact information
Practice address
870 W MIRACLE MILE BLDG 2, TUCSON, AZ 85705-3708
(520) 750-9667
(520) 750-0056
Mailing address
870 W MIRACLE MILE, TUCSON, AZ 85705-3708
(520) 750-9667
(520) 750-0056
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
BH3029
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
APPLIED
—
AZ
Enumeration date
01/03/2008
Last updated
01/03/2008
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