Organization
LA PALOMA FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID T BRADLEY (CEO)
(520) 750-9667
Entity
Organization
Contact information
Practice address
870 W MIRACLE MILE, 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
BH3023
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
885957
—
AZ
Enumeration date
10/25/2006
Last updated
12/19/2007
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