LOLOMA HOUSE LLC
Residential Treatment Facilities at Shangri La Rd, Peoria, AZ

License number
Arizona BH4687
Category
Residential Treatment Facilities
Type
Community Based Residential Treatment Facility, Mental Illness
Owner
Name: LAURA HORNBACK
Title: OWNER/ADMINISTRATIVE OFFICER
Phone: (623) 418-6657
Address
Address
7402 W Shangri La Rd, Peoria, AZ 85345
National Provider ID: 1063886075
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about LOLOMA HOUSE LLC at bizstanding.com

LOLOMA HOUSE LLC

8408 W Willow Ave, Peoria, AZ 85381

Registration:
Jun 5, 2014
State ID:
L-1930939-8
Expiration:
PERPETUAL
Members:
Louis Hornback (Member), 8408 W Willow Ave, Peoria, AZ 85381 (Physical),Laura Hornback (Member), 8408 W Willow Ave, Peoria, AZ 85381 (Physical)
Agent:
United States Corporation Agen,17470 N Pacesetter Way, Scottsdale, AZ 85255 (Physical)

Residential Treatment Facilities licenses in Arizona










Other Doctors licenses in Arizona