Provider Demographics
NPI:1629670450
Name:PARADISE MEMORY CARE
Entity Type:Organization
Organization Name:PARADISE MEMORY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACILITY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAZAR-LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-235-2584
Mailing Address - Street 1:243 SAXONDALE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-6010
Mailing Address - Country:US
Mailing Address - Phone:725-600-7675
Mailing Address - Fax:
Practice Address - Street 1:243 SAXONDALE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-6010
Practice Address - Country:US
Practice Address - Phone:725-600-7675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home