Paradise Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

PCH009059 Issued in GA

Legal business name

PARADISE LIVING

Doing business as

Southern Pines Senior Living

Practice address

258 College Ave
Maysville, GA 30558-1828

Phone

(706) 652-2600

Fax

(706) 652-3523

NPI assigned

May 22, 2015

Last updated

May 22, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Hamid Nikfarjam

Title

Owner

Phone

(706) 652-2600

Specialties & licenses 1

Addresses

Other names 1

• Southern Pines Senior Living Doing business as

Locations

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

{
    "created_epoch": "1432252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432252800000",
    "number": "1952780959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 COLLEGE AVE",
            "city": "MAYSVILLE",
            "state": "GA",
            "postal_code": "305581828",
            "telephone_number": "706-652-2600",
            "fax_number": "706-652-3523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 COLLEGE AVE",
            "city": "MAYSVILLE",
            "state": "GA",
            "postal_code": "305581828",
            "telephone_number": "706-652-2600",
            "fax_number": "706-652-3523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADISE LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-22",
        "last_updated": "2015-05-22",
        "status": "A",
        "authorized_official_last_name": "NIKFARJAM",
        "authorized_official_first_name": "HAMID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-652-2600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "GA",
            "license": "PCH009059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Pines Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Maysville, GA
• Providers in Maysville, GA by specialty
• Assisted Living Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2015; 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.