Paradise Residential Services LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

PARADISE RESIDENTIAL SERVICES LLC

Practice address

6 Stephanie Dr
Gorham, ME 04038-1394

Phone

(207) 636-0009

NPI assigned

Feb 5, 2020

Organization subpart

No

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

Authorized official

Name

Jocelyne Ininahazwe, MA

Title

Chief Executive Manager

Phone

(207) 636-0009

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1580860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631577600000",
    "number": "1497387708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 STEPHANIE DR",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040381394",
            "telephone_number": "207-636-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 STEPHANIE DR",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040381394",
            "telephone_number": "207-636-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADISE RESIDENTIAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-05",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A",
        "authorized_official_last_name": "ININAHAZWE",
        "authorized_official_first_name": "JOCELYNE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE MANAGER",
        "authorized_official_telephone_number": "207-636-0009",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "inijoce@hotmail.fr",
            "affiliation": "N",
            "address_1": "6 Stephanie Dr",
            "city": "Gorham",
            "state": "ME",
            "country_code": "US",
            "postal_code": "040381394",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Gorham, ME
• Providers in Gorham, ME by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.