Active NPI
Paradise Dreams Enterprises, LLC.
- Speech-Language Pathologist
- Henderson, NV
National Provider Identifier
1972098515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Legal business name
- PARADISE DREAMS ENTERPRISES, LLC.
- Practice address
- 1350 Kelso Dunes Ave Apt 1121
Henderson, NV 89014-7858 - Phone
- (631) 903-7018
- NPI assigned
- Jun 26, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Daria Ryan
- Title
- Owner
- Phone
- (631) 903-7018
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Primary |
Addresses
Primary practice location
1350 Kelso Dunes Ave Apt 1121
Henderson, NV 89014-7858
Mailing address
1350 Kelso Dunes Ave Apt 1121
Henderson, NV 89014-7858
Phone (631) 903-7018
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912190273 | Medicaid | CA |
Other names 1
- Smart Start Speech
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529971200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1529971200000",
"number": "1972098515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1350 KELSO DUNES AVE APT 1121",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890147858",
"telephone_number": "631-903-7018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 KELSO DUNES AVE APT 1121",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890147858",
"telephone_number": "631-903-7018"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PARADISE DREAMS ENTERPRISES, LLC.",
"organizational_subpart": "NO",
"enumeration_date": "2018-06-26",
"last_updated": "2018-06-26",
"status": "A",
"authorized_official_last_name": "RYAN",
"authorized_official_first_name": "DARIA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "631-903-7018"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1912190273",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Smart Start Speech",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.