NPIMap

Organization Active NPI

La Paloma Family Services

Doing business as Victoria Group Home

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Tucson, AZ
National Provider Identifier
1699872028
Registry record updated Apr 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
BH-1807 Issued in AZ
Legal business name
LA PALOMA FAMILY SERVICES
Doing business as
Victoria Group Home
Practice address
5457 E 6TH St
Tucson, AZ 85711-2341
Phone
(520) 748-8206
Fax
(520) 750-0056
NPI assigned
Sep 20, 2006
Last updated
Apr 7, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. David T Bradley
Title
Ceo
Phone
(520) 750-9667

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X BH-1807 AZ Primary

Addresses

Primary practice location

5457 E 6TH St
Tucson, AZ 85711-2341

Mailing address

870 W Miracle Mile
Tucson, AZ 85705-3708
Phone (520) 750-9667

Other identifiers 1

IdentifierTypeStateIssuer
649105MedicaidAZ

Other names 1

  • Victoria Group Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
La Paloma Family Services13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239062400000",
    "number": "1699872028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 W MIRACLE MILE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857053708",
            "telephone_number": "520-750-9667",
            "fax_number": "520-750-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5457 E 6TH ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112341",
            "telephone_number": "520-748-8206",
            "fax_number": "520-750-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA PALOMA FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2009-04-07",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "520-750-9667",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "AZ",
            "license": "BH-1807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "649105",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Victoria Group Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.