Provider Demographics
NPI:1023880317
Name:PARAGON OUTPATIENT REHABILITATION SERVICES, LLC
Entity type:Organization
Organization Name:PARAGON OUTPATIENT REHABILITATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP & CHIEF LEGAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIETROWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-412-5847
Mailing Address - Street 1:303 N. HURSTBOURNE PKWY., SUITE 200
Mailing Address - Street 2:ATTN: REVENUE CYCLE
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-5158
Mailing Address - Country:US
Mailing Address - Phone:502-412-5847
Mailing Address - Fax:
Practice Address - Street 1:292 MACDOUGALL DRIVE
Practice Address - Street 2:C/O SEVEN LAKES AL & MC
Practice Address - City:WEST END
Practice Address - State:NC
Practice Address - Zip Code:27376-8300
Practice Address - Country:US
Practice Address - Phone:910-221-4319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRILOGY INVESTORS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation