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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