Provider Demographics
NPI:1245484195
Name:PARADISE HOME CARE, INC.
Entity type:Organization
Organization Name:PARADISE HOME CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEVENSTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:804-562-6604
Mailing Address - Street 1:4906 CUTSHAW AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3630
Mailing Address - Country:US
Mailing Address - Phone:804-562-6604
Mailing Address - Fax:804-308-0551
Practice Address - Street 1:4906 CUTSHAW AVE STE 102
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3630
Practice Address - Country:US
Practice Address - Phone:804-562-6604
Practice Address - Fax:804-308-0551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-05
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health