Organization
LOLOMA HOUSES LLC
Active
Organization
LOLOMA HOUSES LLC
Active
Parent organization
LOLOMA HOUSE LLC
Other names
Loloma House at Greenway, Loloma House at Sunnyside
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOLOMA HOUSE LLC
Authorized official
MRS. LAURA ADILOBA HORNBACK (OWNER / ADMINISTRATOR)
(623) 418-6657
Entity
Organization
Contact information
Practice address
6125 W SUNNYSIDE DR, GLENDALE, AZ 85304-2533
(623) 418-6657
Mailing address
8408 W WILLOW AVE, PEORIA, AZ 85381-4864
(623) 418-6657
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942743711
—
AZ
Enumeration date
03/12/2020
Last updated
03/27/2020
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