| Paradise Treatment Services I LLC | |
|
4530 E Ray Rd Ste 172 Phoenix AZ 85044-6099 | |
| (202) 718-9939 | |
| Not Available |
| Full Name | Paradise Treatment Services I LLC |
|---|---|
| Speciality | Clinic/center |
| Location | 4530 E Ray Rd Ste 172, Phoenix, Arizona |
| Authorized Official Name and Position | Clovis Hermann Lawin (OWNER) |
| Authorized Official Contact | 2027189939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Paradise Treatment Services I LLC 4530 E Ray Rd Ste 172 Phoenix AZ 85044-6099 Ph: (202) 718-9939 | Paradise Treatment Services I LLC 4530 E Ray Rd Ste 172 Phoenix AZ 85044-6099 Ph: (202) 718-9939 |
| NPI Number | 1639815467 |
|---|---|
| Provider Enumeration Date | 05/05/2022 |
| Last Update Date | 05/05/2022 |
| Certification Date | 05/05/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639815467 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Primary |
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