Paradise Lodge LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PARADISE LODGE LLC

Doing business as

New Dawn Behavioral Health

Practice address

18860 N Maricopa Rd
Maricopa, AZ 85139-1817

Phone

(122) 459-5011

NPI assigned

Nov 29, 2023

Organization subpart

No

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

Authorized official

Name

Ernest K Amponsah

Title

Administrator

Phone

(224) 595-0112

Specialties & licenses 7

Addresses

Other names 1

• New Dawn Behavioral Health Doing business as

Tax ID family

New Dawn Behavioral Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Paradise Lodge LLC

  • Substance Abuse Rehabilitation Facility
  • Maricopa, AZ
  • NPI 1093386450
  NPD tax ID

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

{
    "created_epoch": "1701216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701216000000",
    "number": "1952177115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43858 W LINDGREN DR",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851385523",
            "telephone_number": "224-595-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18860 N MARICOPA RD",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851391817",
            "telephone_number": "122-459-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADISE LODGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-29",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A",
        "authorized_official_last_name": "AMPONSAH",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "224-595-0112"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Dawn Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mirna Pacheco, LPC
• Harlan Page, RN
• Angelica G Palmer, LPN
• Paradigm Hospital Group, LLC
• Paradise Lodge LLC
• Paradise Palace Behavioral Health LLC
• Parent Helpers, LLC
• Lynette Parker-Koger
• Jinal Patel, DMD
• Pathway Behavioral Health LLC

• Community/Behavioral Health Agency in Maricopa, AZ
• Providers in Maricopa, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.