Provider Demographics
NPI:1891092201
Name:LA PALOMA HOMECARE, LLC
Entity Type:Organization
Organization Name:LA PALOMA HOMECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:DIOSCORO
Authorized Official - Middle Name:ANGELES
Authorized Official - Last Name:TAGLE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:520-544-4663
Mailing Address - Street 1:12470 N RANCHO VISTOSO BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85755-1878
Mailing Address - Country:US
Mailing Address - Phone:520-544-4663
Mailing Address - Fax:520-566-4111
Practice Address - Street 1:12470 N RANCHO VISTOSO BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755-1878
Practice Address - Country:US
Practice Address - Phone:520-544-4663
Practice Address - Fax:520-566-4111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-21
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health