Provider Demographics
NPI: | 1811610504 |
---|---|
Name: | PARAGON BEHAVIORAL LLC |
Entity type: | Organization |
Organization Name: | PARAGON BEHAVIORAL LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DIRECTOR OF OPERATIONS |
Authorized Official - Prefix: | |
Authorized Official - First Name: | LAUREN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ROMERO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 435-275-2752 |
Mailing Address - Street 1: | 116 E CITY CENTER ST |
Mailing Address - Street 2: | |
Mailing Address - City: | ST GEORGE |
Mailing Address - State: | UT |
Mailing Address - Zip Code: | 84770-3460 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 435-275-2752 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 116 E CITY CENTER ST |
Practice Address - Street 2: | |
Practice Address - City: | ST GEORGE |
Practice Address - State: | UT |
Practice Address - Zip Code: | 84770-3460 |
Practice Address - Country: | US |
Practice Address - Phone: | 435-275-2752 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2022-09-19 |
Last Update Date: | 2022-09-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health | |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |
No | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | Group - Multi-Specialty | |
No | 251B00000X | Agencies | Case Management | ||
No | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | ||
No | 251S00000X | Agencies | Community/Behavioral Health | ||
No | 252Y00000X | Agencies | Early Intervention Provider Agency | ||
No | 253J00000X | Agencies | Foster Care Agency | ||
No | 322D00000X | Residential Treatment Facilities | Residential Treatment Facility, Emotionally Disturbed Children | ||
No | 323P00000X | Residential Treatment Facilities | Psychiatric Residential Treatment Facility | ||
No | 3245S0500X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children | |
No | 385HR2055X | Respite Care Facility | Respite Care | Respite Care, Mental Illness, Child | |
No | 385HR2060X | Respite Care Facility | Respite Care | Respite Care, Intellectual and/or Developmental Disabilities, Child | |
No | 385HR2065X | Respite Care Facility | Respite Care | Respite Care, Physical Disabilities, Child |