NPIMap

Organization Active NPI

Paradise Ranch, LLC

  • Community/Behavioral Health Agency
  • Las Vegas, NV
National Provider Identifier
1104162155
Registry record updated Dec 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PARADISE RANCH, LLC
Practice address
1722 Primrose Path
Las Vegas, NV 89108-1918
Phone
(702) 515-7117
NPI assigned
Dec 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Paul Donald Rogers IIINPI 1447519095
Title
Director
Phone
(702) 515-7117

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1722 Primrose Path
Las Vegas, NV 89108-1918

Mailing address

1722 Primrose Path
Las Vegas, NV 89108-1918

Other identifiers 1

IdentifierTypeStateIssuer
1447519095MedicaidNV

National Provider Directory

National Provider Directory

Locations

1722 Primrose Path
Las Vegas, NV 89108
Phone (702) 515-7117

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1355875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355875200000",
    "number": "1104162155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 PRIMROSE PATH",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891081918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 PRIMROSE PATH",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891081918",
            "telephone_number": "702-515-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADISE RANCH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-19",
        "last_updated": "2012-12-19",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "DONALD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "702-515-7117",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447519095",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.