NPI 1063886075

Loloma House LLC

Organisation Mental Illness Community Based Residential Treatment Facility Peoria, AZ

Practice location

Address: 7402 W Shangri La Rd, Peoria, AZ 85345-5812
Phone: (623) 418-6657

Authorised official

Name: Laura Hornback
Title: Owner/Administrative Officer
Phone: (623) 418-6657

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X Licence BH4687 (AZ)

Other Community Based Residential Treatment Facility, Mental Illness providers in Arizona →

Registry record

NPI: 1063886075
Entity type: Organization
NPI issued: 16 Nov 2015
Record last updated: 16 Nov 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.