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Contact Information

PARADISE LODGE LLC
18860 N MARICOPA RD
MARICOPA, AZ85139-1817
 Phone: 122-459-5011
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
 

Adult Mental Health

261QM0850X
 

Case Management

251B00000X
 

Health Service

261QH0100X
 

Primary Care

363LP2300X 50 Nurse Practitioner
 

Professional

101YP2500X
 

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for PARADISE LODGE LLC

NPI Number 1952177115
LBN Legal business name PARADISE LODGE LLC
Authorized official ERNEST AMPONSAH - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 11/29/2023
Last updated 11/29/2023 - About 3 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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