Provider Demographics
NPI:1659586329
Name:PARADISE VALLEY HOSPITAL
Entity Type:Organization
Organization Name:PARADISE VALLEY HOSPITAL
Other - Org Name:PRIME ALLY PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:R
Authorized Official - Last Name:RAMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:619-585-4631
Mailing Address - Street 1:330 MOSS ST
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-2005
Mailing Address - Country:US
Mailing Address - Phone:619-426-6310
Mailing Address - Fax:
Practice Address - Street 1:502 EUCLID AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-2982
Practice Address - Country:US
Practice Address - Phone:619-267-5115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA090000086101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty