Provider Demographics
NPI:1871652735
Name:PARADISE HOME CARE, INC.
Entity Type:Organization
Organization Name:PARADISE HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF HOME HEALTH OPERATIONS
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-BC
Authorized Official - Phone:703-201-1264
Mailing Address - Street 1:10043 MIDLOTHIAN TPKE
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-4856
Mailing Address - Country:US
Mailing Address - Phone:804-288-0033
Mailing Address - Fax:804-288-0035
Practice Address - Street 1:10043 MIDLOTHIAN TPKE
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-4856
Practice Address - Country:US
Practice Address - Phone:804-288-0033
Practice Address - Fax:804-288-0035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA497628Medicare Oscar/Certification