Provider Demographics
NPI:1396256186
Name:PARAGON SUPPORT SERVICES
Entity type:Organization
Organization Name:PARAGON SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ADDY
Authorized Official - Middle Name:ROSMARY
Authorized Official - Last Name:CUMLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-462-2075
Mailing Address - Street 1:17 MAXIM CT
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:ME
Mailing Address - Zip Code:04364-1408
Mailing Address - Country:US
Mailing Address - Phone:207-592-9260
Mailing Address - Fax:
Practice Address - Street 1:17 MAXIM CT
Practice Address - Street 2:
Practice Address - City:WINTHROP
Practice Address - State:ME
Practice Address - Zip Code:04364-1408
Practice Address - Country:US
Practice Address - Phone:207-592-9260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-19
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty