Provider Demographics
NPI:1912501321
Name:PARAISO ATTENDANT SERVICES, LLC
Entity type:Organization
Organization Name:PARAISO ATTENDANT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:REGANALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MACKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-694-3723
Mailing Address - Street 1:2550 W UNION HILLS DR STE 350
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-5187
Mailing Address - Country:US
Mailing Address - Phone:915-247-6129
Mailing Address - Fax:915-642-0045
Practice Address - Street 1:3301 AIRPORT FWY STE 340A
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-6032
Practice Address - Country:US
Practice Address - Phone:915-247-6129
Practice Address - Fax:915-642-0045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-25
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No251E00000XAgenciesHome Health