# LA PALOMA FAMILY SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Diamondback Level III Group Home Girls
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700966231
- **Authorized official:** MR. DAVID T BRADLEY (CEO)
- **Authorized official phone:** (520) 750-9667

## Contact information

- **Practice address:** 1654 N ROSEMONT BLVD, TUCSON, AZ 85712-4141
- **Practice address phone:** (520) 750-9667
- **Practice address fax:** (520) 750-0056
- **Mailing address:** 880 S CRAYCROFT RD, TUCSON, AZ 85711-7111
- **Mailing address phone:** (520) 750-9667
- **Mailing address fax:** (520) 750-0056

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | BH-1712 | AZ | Yes |

## Other

- **Enumeration date:** 10/17/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 964248 | — | AZ |