Provider Demographics
NPI:1821488867
Name:LA PALOMA FAMILY SERVICES
Entity Type:Organization
Organization Name:LA PALOMA FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HCTC LICENSING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SLADEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-750-9667
Mailing Address - Street 1:870 W MIRACLE MILE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-3708
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5702 E 14TH ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-4567
Practice Address - Country:US
Practice Address - Phone:520-271-5258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1493853253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency