Provider Demographics
NPI:1831452176
Name:PARAMOUNT RECOVERY LLC
Entity type:Organization
Organization Name:PARAMOUNT RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KENDALL
Authorized Official - Middle Name:D
Authorized Official - Last Name:HEIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW, LCAC
Authorized Official - Phone:785-218-9096
Mailing Address - Street 1:1040 NEW HAMPSHIRE ST
Mailing Address - Street 2:SUITE 26
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-3044
Mailing Address - Country:US
Mailing Address - Phone:785-371-1455
Mailing Address - Fax:866-493-2129
Practice Address - Street 1:1040 NEW HAMPSHIRE ST
Practice Address - Street 2:SUITE 26
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-3044
Practice Address - Country:US
Practice Address - Phone:785-371-1455
Practice Address - Fax:866-493-2129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS192101YA0400X
KS40681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty