LA PALOMA FAMILY SERVICES (NPI# 1265512776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265512776 |
| Entity Type | Organization |
| Organization Name | LA PALOMA FAMILY SERVICES |
| Other Organization Name | EVERGREEN FACILITY |
| Practice Address |
4321 S Evergreen Ave Tucson AZ 85730-4005 |
| Mailing Address |
880 S Craycroft Rd Tucson AZ 85711-7111 |
| Practice Telephone | 5207508679 |
| Practice Fax Number | 5207500056 |
| Mailing Telephone | 5207509667 |
| Mailing Fax Number | 5207500056 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. DAVID T BRADLEY (CFO) |
| Authorized Official Telephone | 5207509667 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | BH-613 | AZ | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 102822 | 05 |
| Other Name | Type Code |
|---|---|
| Evergreen Facility | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821488867 | La Paloma Family Services | Foster Care Agency | 5702 E 14th St, Tucson, AZ 85711-4567 | 2015-01-29 |
| 1548687601 | La Paloma Family Services | Foster Care Agency | 7880 S Castle Bay St, Tucson, AZ 85747-9229 | 2014-03-26 |
| 1518142033 | La Paloma Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 870 W Miracle Mile Bldg 2, Tucson, AZ 85705-3708 | 2008-01-03 |
| 1710190061 | La Paloma Family Services | Community/Behavioral Health | 880 S Craycroft Rd, Tucson, AZ 85711-7111 | 2007-05-07 |
| 1477766723 | La Paloma Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 1718 N Mckinley Ave, Tucson, AZ 85712-3726 | 2007-05-07 |
| 1700961224 | La Paloma Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 870 W Miracle Mile, Tucson, AZ 85705-3708 | 2006-10-25 |
| 1083794564 | La Paloma Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 8400 E Timrod St, Tucson, AZ 85710-4255 | 2006-10-17 |
| 1700966231 | La Paloma Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 1654 N Rosemont Blvd, Tucson, AZ 85712-4141 | 2006-10-17 |
| 1124116678 | La Paloma Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 240 W Navajo Rd, Tucson, AZ 85705-3514 | 2006-10-10 |
| 1699872028 | La Paloma Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 5457 E 6th St, Tucson, AZ 85711-2341 | 2006-09-20 |
| Street Address |
4321 S EVERGREEN AVE |
| City | TUCSON |
| State | AZ |
| Zip Code | 85730-4005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871019927 | Jacques Boubeka | Behavior Technician | 9047 E Mayberry Dr, Tucson, AZ 85730 | 2017-08-21 |
| 1801266556 | Jennifer Budd | Nurse Practitioner | 2435 N. Castro Avenue, Tucson, AZ 85730 | 2015-10-06 |
| 1285037648 | Eden Huang | Physician Assistant | 6950 E Golf Links, Tucson, AZ 85730 | 2014-09-30 |
| 1881002376 | Chisom P Umogbai | Optometrist | 7046 E Golf Links Rd, Tucson, AZ 85730 | 2014-07-28 |
| 1720490154 | Integrity Counseling Services, Plc | Counselor | 11092 E. Placita Cumbia, Tucson, AZ 85730 | 2014-05-20 |
| 1619399276 | Karla J. Gracia | Counselor | 8050 E. Lakeside Pkwy, Tucson, AZ 85730 | 2014-01-15 |
| 1780934505 | Kendrah Jordan Davis | Contractor | 3226 South Lakeside Drive, Tucson, AZ 85730 | 2012-09-19 |
| 1619287620 | Mukesh N Shah | Physician Assistant | 6455 E Nelson Dr, Tucson, AZ 85730 | 2010-10-12 |
| 1568770154 | Steven Fabian Wautlet | Pharmacist | 7771 E. Golf Links Road, Tucson, AZ 85730 | 2010-09-17 |
| 1033239942 | Franciso Garcia | Psychiatry & Neurology | 8050 East Lakeside Parkway, Cope Community Services, Inc., Tucson, AZ 85730 | 2007-04-02 |
| Find all providers in zip 85730 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033756358 | Native Music Coalition | Residential Treatment Facility, Emotionally Disturbed Children | 5150 S Crazy Cat Ln, Tucson, AZ 85735 | 2019-12-05 |
| 1538668983 | Starks Homes LLC | Residential Treatment Facility, Emotionally Disturbed Children | 7325 E Fayette St, Tucson, AZ 85730-2324 | 2018-02-12 |
| 1417349028 | Intermountain Centers for Human Develoment Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 8851 East Tanque Verde, Tucson, AZ 85749 | 2015-02-19 |
| 1063749521 | Casa De Tucson LLC | Residential Treatment Facility, Emotionally Disturbed Children | 5055 W Pima Farms Rd, Tucson, AZ 85741-4736 | 2009-11-04 |
| 1417128950 | New Beginnings Treatment Center, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 2937 N Stone Ave, Tucson, AZ 85705-5915 | 2008-03-12 |
| 1417134933 | Intermountain Centers for Human Development Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1310 N Speedway Pl, Tucson, AZ 85715-5236 | 2008-01-28 |
| 1518142033 | La Paloma Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 870 W Miracle Mile Bldg 2, Tucson, AZ 85705-3708 | 2008-01-03 |
| 1538341458 | New Beginnings Treatment Center, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 2445 N Oracle Rd, Tucson, AZ 85705-4321 | 2007-12-03 |
| 1467661470 | Pascua Yaqui Tribe | Residential Treatment Facility, Emotionally Disturbed Children | 2861 W Via Hacienda, Tucson, AZ 85741-3424 | 2007-05-22 |
| 1477766723 | La Paloma Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 1718 N Mckinley Ave, Tucson, AZ 85712-3726 | 2007-05-07 |
| Find all providers in TUCSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.