Healthcare Provider Details

I. General information

NPI: 1457291361
Provider Name (Legal Business Name): PERFECT PARADISE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45341 W PARAISO LN
MARICOPA AZ
85139-8787
US

IV. Provider business mailing address

10209 W PRESTON LN
TOLLESON AZ
85353-1273
US

V. Phone/Fax

Practice location:
  • Phone: 206-919-1710
  • Fax:
Mailing address:
  • Phone: 206-919-1710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: BRIDGET TALLEY-QUARLES
Title or Position: OWNER
Credential:
Phone: 206-919-1710