Healthcare Provider Details

I. General information

NPI: 1245829449
Provider Name (Legal Business Name): PARADIGM SENIOR MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2021
Last Update Date: 01/12/2021
Certification Date: 01/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 N CATALPA ST
DEXTER MO
63841-1608
US

IV. Provider business mailing address

230 N CATALPA ST
DEXTER MO
63841-1608
US

V. Phone/Fax

Practice location:
  • Phone: 573-614-7472
  • Fax: 833-471-3364
Mailing address:
  • Phone: 573-614-7472
  • Fax: 833-471-3364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: BEN P SELLS
Title or Position: CEO/MEMBER
Credential:
Phone: 573-614-7472