Provider Demographics
NPI:1972397743
Name:PARADISE OF ADORATION LLC
Entity type:Organization
Organization Name:PARADISE OF ADORATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SKANNAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-504-6072
Mailing Address - Street 1:5110 PEACHGREEN CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-4877
Mailing Address - Country:US
Mailing Address - Phone:813-504-6072
Mailing Address - Fax:813-504-6072
Practice Address - Street 1:5110 PEACHGREEN CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-4877
Practice Address - Country:US
Practice Address - Phone:813-504-6072
Practice Address - Fax:813-504-6072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility