Provider Demographics
NPI:1386781995
Name:PARADISE HEALTHCARE, INC
Entity type:Organization
Organization Name:PARADISE HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:EHIMEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-434-1900
Mailing Address - Street 1:2810 SPRING RD SE STE 112
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3066
Mailing Address - Country:US
Mailing Address - Phone:770-434-1900
Mailing Address - Fax:770-434-1992
Practice Address - Street 1:2810 SPRING RD SE STE 112
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-3066
Practice Address - Country:US
Practice Address - Phone:770-434-1900
Practice Address - Fax:770-434-1992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033-R-0090251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health