Provider Demographics
NPI:1235329897
Name:PARADISE RECOVERY, LLC
Entity Type:Organization
Organization Name:PARADISE RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR AND CO-FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PARTRICK
Authorized Official - Last Name:NEUHAUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:1808-386-6332
Mailing Address - Street 1:1050 BISHOP ST
Mailing Address - Street 2:STE 162
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4210
Mailing Address - Country:US
Mailing Address - Phone:808-206-8462
Mailing Address - Fax:866-241-7463
Practice Address - Street 1:7017 KALANIANAOLE HWY
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-2007
Practice Address - Country:US
Practice Address - Phone:808-206-8462
Practice Address - Fax:866-241-7463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HISTF 86324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility