Provider Demographics
NPI:1154661007
Name:PARADIGM HEALTH SYSTEM
Entity Type:Organization
Organization Name:PARADIGM HEALTH SYSTEM
Other - Org Name:NORTHLAKE NEUROLOGICAL INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:J
Authorized Official - Last Name:MORREAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-801-0581
Mailing Address - Street 1:90 LOUIS PRIMA DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-5903
Mailing Address - Country:US
Mailing Address - Phone:985-801-0581
Mailing Address - Fax:985-871-8109
Practice Address - Street 1:90 LOUIS PRIMA DR
Practice Address - Street 2:SUITE B
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-5903
Practice Address - Country:US
Practice Address - Phone:985-801-0581
Practice Address - Fax:985-871-8109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-28
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty