Provider Demographics
NPI:1093801219
Name:PARAGON HOME HEALTHCARE, INC.
Entity Type:Organization
Organization Name:PARAGON HOME HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BALA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEDDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-343-0900
Mailing Address - Street 1:601 E CENTRE AVE
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49002-5514
Mailing Address - Country:US
Mailing Address - Phone:269-343-0900
Mailing Address - Fax:269-343-0990
Practice Address - Street 1:601 E CENTRE AVE
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49002-5514
Practice Address - Country:US
Practice Address - Phone:269-343-0900
Practice Address - Fax:269-343-0990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health