LOLOMA HOUSE LLC (NPI# 1942743711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942743711 |
| Entity Type | Organization |
| Organization Name | LOLOMA HOUSE LLC |
| Practice Address |
15259 N 67th Dr Peoria AZ 85381-4502 |
| Practice Telephone | 6234186657 |
| Practice Fax Number | 6233228664 |
| Mailing Telephone | 6234186657 |
| Mailing Fax Number | 6233228664 |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2016-11-30 |
| Authorized Official Name | MRS. LAURA HORNBACK (OWNER/ADMINISTRATIVE OFFICER) |
| Authorized Official Telephone | 6234186657 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | BH4687 | AZ | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063886075 | Loloma House LLC | Community Based Residential Treatment Facility, Mental Illness | 7402 W Shangri La Rd, Peoria, AZ 85345-5812 | 2015-11-16 |
| Street Address |
15259 N 67TH DR |
| City | PEORIA |
| State | AZ |
| Zip Code | 85381-4502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932712122 | Vicki L Grenier | Registered Nurse | 7558 W. Thunderbird Rd. Ste 1-507, Peoria, AZ 85381 | 2020-08-26 |
| 1568934107 | Earthwalk Wellness Group, LLC | Social Worker | 14050 North 83rd Avenue, Suite 290, Peoria, AZ 85381 | 2018-12-20 |
| 1316412059 | John & Biljana Feeley Dba J & B Assisted Living IIi Inc | Community Based Residential Treatment Facility, Mental Illness | 7331 W Sweetwater Avenue, Peoria, AZ 85381 | 2018-10-09 |
| 1467958611 | Arizona Community Pharmacy | Pharmacy | 14100 N 83rd Ave Ste 160, Peoria, AZ 85381 | 2018-04-04 |
| 1083112106 | Marissa Lynn Desjardins | Physical Therapist | 8240 W. Cactus Rd. Oakeson Physical Therapy, Peoria, AZ 85381 | 2018-01-23 |
| 1235651399 | Power Back Batteries LLC | Durable Medical Equipment & Medical Supplies | 9054 West Lisbon Ave, Peoria, AZ 85381 | 2017-07-11 |
| 1457897027 | Sonoran Sky Community Services | Community Based Residential Treatment Facility, Mental Illness | 7524 W. Alexandria Way, Peoria, AZ 85381 | 2017-01-06 |
| 1386023448 | Scott Boone | Registered Nurse | 7715 W Watson Ln, Peoria, AZ 85381 | 2015-05-22 |
| 1881084838 | Pinnacle Women's Center LLC | Obstetrics & Gynecology | 15396 N 83rd Ave Ste F100, Peoria, AZ 85381 | 2015-01-29 |
| 1245637081 | Kathi Locke | Counselor | 13460 N. 94th Drive, Suite J2, Peoria, AZ 85381 | 2014-11-21 |
| Find all providers in zip 85381 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952913998 | Vema Corporation | Community Based Residential Treatment Facility, Mental Illness | 12701 N 79th Dr, Peoria, AZ 85381-9049 | 2020-08-20 |
| 1851926166 | Miss A's LLC | Community Based Residential Treatment Facility, Mental Illness | 9143 N 82nd Ln, Peoria, AZ 85345-4827 | 2020-03-06 |
| 1316412059 | John & Biljana Feeley Dba J & B Assisted Living IIi Inc | Community Based Residential Treatment Facility, Mental Illness | 7331 W Sweetwater Avenue, Peoria, AZ 85381 | 2018-10-09 |
| 1871095232 | Loving Hands LLC | Community Based Residential Treatment Facility, Mental Illness | 9323 W Harmony Ln, Peoria, AZ 85382-8374 | 2018-03-01 |
| 1316453913 | Love for The Children Group Home | Community Based Residential Treatment Facility, Mental Illness | 20277 N 93rd Ave, Peoria, AZ 85382-5319 | 2017-12-18 |
| 1265967012 | Abba Behavioral Health,llc | Community Based Residential Treatment Facility, Mental Illness | 21388 N 106th Ln, Peoria, AZ 85382-0522 | 2017-04-28 |
| 1114465978 | Orion Homes LLC | Community Based Residential Treatment Facility, Mental Illness | 8302 W Donald Dr, Peoria, AZ 85383-2041 | 2017-02-01 |
| 1457897027 | Sonoran Sky Community Services | Community Based Residential Treatment Facility, Mental Illness | 7524 W. Alexandria Way, Peoria, AZ 85381 | 2017-01-06 |
| 1447795992 | Miss A's LLC | Community Based Residential Treatment Facility, Mental Illness | 8606 N 68th Ln, Peoria, AZ 85345-8451 | 2016-12-19 |
| 1073055737 | Elena Babetz | Community Based Residential Treatment Facility, Mental Illness | 22432 N 80th Ln, Peoria, AZ 85383-2149 | 2016-11-12 |
| Find all providers in PEORIA | ||||
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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.