Healthcare Provider Details

I. General information

NPI: 1629852231
Provider Name (Legal Business Name): PARAGON OUTPATIENT REHABILITATION SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2023
Last Update Date: 08/23/2023
Certification Date: 08/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 VILLAGE LAKE RD
SILER CITY NC
27344-1820
US

IV. Provider business mailing address

PO BOX 74590
CLEVELAND OH
44194-0002
US

V. Phone/Fax

Practice location:
  • Phone: 919-794-3001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CRISTINA PIETROWSKI
Title or Position: SVP & CHIEF LEGAL OFFICER
Credential:
Phone: 502-412-5847