Evergreen Facility

LBN: La Paloma Family Services
Evergreen Facility is an health care organization with primary practice located at 4321 S Evergreen Ave , Tucson AZ 85730-4005. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children, which is considered as the primary health care specialty. La Paloma Family Services can be contacted via phone (520) 750-8679, or through Bradley, David T via phone (520) 750-9667.

Contact Information

Primary practice address
4321 S Evergreen Ave Tucson AZ 85730-4005
Phone: (520) 750-8679
Fax: (520) 750-0056
Website:
Map and Directions
Authorized official contact:
Name: Bradley, David T
Phone: (520) 750-9667

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children 322D00000X BH-613 Arizona

Profile Details

NPI number 1265512776
LBN Legal business name La Paloma Family Services
DBA Doing business as Evergreen Facility
Authorized official Bradley, David T
Entity Organization
Organization subpart 1 No
Enumeration date Oct 17th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265512776 NPPES
Arizona MEDICAID 102822

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