Organization
LA PALOMA FAMILY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA WHITEHEAD (EXECUTIVE DIRECTOR)
(520) 206-8659
Entity
Organization
Contact information
Practice address
870 W MIRACLE MILE, BLDG 1, TUCSON, AZ 85705-3708
(520) 750-9667
Mailing address
870 W MIRACLE MILE, BLDG 1, TUCSON, AZ 85705-3708
(520) 750-9667
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
4170
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4170
OBHL
AZ
Enumeration date
03/28/2013
Last updated
03/28/2013
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