Loloma House LLC

NPI #1942743711 in Peoria, Arizona

Provider Information

NPI Number: 1942743711
Entity Type: Organization
Organization Name: Loloma House LLC
Primary Specialty: Community Based Residential Treatment Facility, Mental Illness
Enumeration Date: Nov 29, 2016
Last Updated: Nov 30, 2016

Practice Location

Address: 15259 N 67TH DR
City: Peoria
State: Arizona
ZIP Code: 85381-4502
Phone: (623) 418-6657

Authorized Official

Name: MRS. LAURA HORNBACK
Title: OWNER/ADMINISTRATIVE OFFICER
Phone: (623) 418-6657

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Mental Illness	320800000X	Primary

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