Paradise Detox, Inc

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

PARADISE DETOX, INC

Practice address

5935 Joel LN
La Mesa, CA 91942-4101

Phone

(855) 756-2013

NPI assigned

Oct 17, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Robert Niznik

Title

Ceo

Phone

(855) 756-2013

Specialties & licenses 2

Addresses

Other names 1

• Paradise Detox, Inc Doing business as

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591228800000",
    "number": "1972014041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 NW 167TH ST STE 300",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331695106",
            "telephone_number": "786-923-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5935 JOEL LN",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919424101",
            "telephone_number": "855-756-2013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADISE DETOX, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-17",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A",
        "authorized_official_last_name": "NIZNIK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "855-756-2013",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paradise Detox, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nita Paintal, MD
• Melanie Purificacion Pajimula, CPHT
• Anngela Palacio
• Palm Detox, Inc
• Wendy Ann Panagos, MFT
• Julian Parent, PA-C
• Lena Pargo
• Jin Hee Park, L.AC.
• Joseph Park, PT
• Michelle C Park

• Substance Abuse Rehabilitation Facility in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; 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.