Provider Demographics
NPI:1104362722
Name:PARADISE HOME HEALTH LLC
Entity Type:Organization
Organization Name:PARADISE HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:H
Authorized Official - Middle Name:
Authorized Official - Last Name:NATHIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-498-6690
Mailing Address - Street 1:224 N LINDBERGH BLVD
Mailing Address - Street 2:SUITE 13
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031-5904
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:224 N LINDBERGH BLVD
Practice Address - Street 2:SUITE 13
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-5904
Practice Address - Country:US
Practice Address - Phone:636-498-9201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-07
Last Update Date:2017-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO251B00000X, 251E00000X, 253Z00000X
251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care