Provider Demographics
NPI:1104172568
Name:PARADISE ADULTS CARE
Entity type:Organization
Organization Name:PARADISE ADULTS CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-323-8552
Mailing Address - Street 1:PO BOX 30752
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON ISLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31410-0752
Mailing Address - Country:US
Mailing Address - Phone:912-323-8552
Mailing Address - Fax:
Practice Address - Street 1:124 ROPEMAKER LN
Practice Address - Street 2:4 BELVEDERE DRIVE
Practice Address - City:WILMINGTON ISLAND
Practice Address - State:GA
Practice Address - Zip Code:31410-2018
Practice Address - Country:US
Practice Address - Phone:912-335-2991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-02
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA025013271I311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home