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Organization
LA PALOMA FAMILY SERVICES
Active
Organization
LA PALOMA FAMILY SERVICES
Active
Other names
Diamondback Level III Group Home Girls
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID T BRADLEY (CEO)
(520) 750-9667
Entity
Organization
Contact information
Practice address
1654 N ROSEMONT BLVD, TUCSON, AZ 85712-4141
(520) 750-9667
(520) 750-0056
Mailing address
880 S CRAYCROFT RD, TUCSON, AZ 85711-7111
(520) 750-9667
(520) 750-0056
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
BH-1712
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
964248
—
AZ
Enumeration date
10/17/2006
Last updated
08/22/2020
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