Healthcare Provider Details

I. General information

NPI: 1578334595
Provider Name (Legal Business Name): PARADISE HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2024
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 ATLANTIC AVE UNIT 201B
MARBLEHEAD MA
01945-3067
US

IV. Provider business mailing address

52 BROOKHOUSE DR
MARBLEHEAD MA
01945-1611
US

V. Phone/Fax

Practice location:
  • Phone: 978-216-3804
  • Fax: 949-695-4067
Mailing address:
  • Phone: 781-691-1733
  • Fax: 949-695-4067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AL BERRY
Title or Position: AUTHORIZED OFFICIAL/OWNER
Credential: NP
Phone: 469-915-4211