Provider Demographics
NPI:1063647428
Name:PARAGON OUTPATIENT THERAPY SERVICES
Entity Type:Organization
Organization Name:PARAGON OUTPATIENT THERAPY SERVICES
Other - Org Name:PARAGON HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MEG
Authorized Official - Middle Name:T
Authorized Official - Last Name:CORSINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-214-6665
Mailing Address - Street 1:1655 W HORIZON RIDGE PKWY
Mailing Address - Street 2:STE 100
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-3494
Mailing Address - Country:US
Mailing Address - Phone:702-914-2790
Mailing Address - Fax:702-914-5984
Practice Address - Street 1:7324 W CHEYENNE AVE
Practice Address - Street 2:STE 7
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-7427
Practice Address - Country:US
Practice Address - Phone:702-214-6665
Practice Address - Fax:702-214-6865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2279P1005XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary RehabilitationGroup - Multi-Specialty