Healthcare Provider Details
I. General information
NPI: 1881076990
Provider Name (Legal Business Name): PARAGON CONGREGATE LIVING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/25/2015
Last Update Date: 06/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
834 E ELMWOOD AVE
BURBANK CA
91501-1530
US
IV. Provider business mailing address
834 E ELMWOOD AVE
BURBANK CA
91501-1530
US
V. Phone/Fax
- Phone: 888-820-5353
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HAROUT
MARKARIAN
Title or Position: CEO
Credential:
Phone: 888-820-5353