Provider Demographics
NPI:1689068934
Name:A PARADISE HOME ALF INC
Entity Type:Organization
Organization Name:A PARADISE HOME ALF INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:USHINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-591-1025
Mailing Address - Street 1:13219 44TH PL N
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-8418
Mailing Address - Country:US
Mailing Address - Phone:561-727-8854
Mailing Address - Fax:561-727-8854
Practice Address - Street 1:13219 44TH PL N
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-8418
Practice Address - Country:US
Practice Address - Phone:561-727-8854
Practice Address - Fax:561-727-8854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-25
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL12144310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008752700Medicaid