Paradise Group Home LLC
Organization Active NPI Point of Service · Risco, MO
NPI 1497210629 · NPPES record last updated Feb 1, 2019
Key facts
- NPI
- 1497210629
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Point of Service 305S00000X
- Legal business name
- PARADISE GROUP HOME LLC
- Practice address
- 121 Front Street
Risco, MO 63874 - Phone
- (573) 394-5020
- Fax
- (573) 394-5022
- NPI assigned
- Feb 1, 2019
- Organization subpart
- No
Authorized official
- Name
- Mrs. Jerrilyn Diane Adkisson
- Title
- Owner
- Phone
- (573) 471-3770
Practitioners 1
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Point of Service | 305S00000X | Yes |
Addresses
Primary practice location
121 Front Street
Risco, MO 63874
Mailing address
208 N Ingram Rd
Sikeston, MO 63801-5233
Phone (573) 471-3770
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.