Provider Demographics
NPI:1306387063
Name:HOUSE OF PARADISE LLC
Entity type:Organization
Organization Name:HOUSE OF PARADISE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-244-4583
Mailing Address - Street 1:1201 NW BRIARCLIFF PKWY
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-1878
Mailing Address - Country:US
Mailing Address - Phone:913-244-4583
Mailing Address - Fax:888-854-8514
Practice Address - Street 1:1201 NW BRIARCLIFF PKWY
Practice Address - Street 2:2ND FLOOR
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-1878
Practice Address - Country:US
Practice Address - Phone:913-244-4583
Practice Address - Fax:888-854-8514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-14
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities