Provider Demographics
NPI:1740947316
Name:PARADISE THERAPEUTIC SERVICE LLC
Entity type:Organization
Organization Name:PARADISE THERAPEUTIC SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERLYN
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:CYRES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:225-279-5640
Mailing Address - Street 1:7640 ADVENTURE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70129-2740
Mailing Address - Country:US
Mailing Address - Phone:504-656-6440
Mailing Address - Fax:
Practice Address - Street 1:1901 AIRLINE DR STE B
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-5936
Practice Address - Country:US
Practice Address - Phone:504-656-6440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-18
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty