Healthcare Provider Details

I. General information

NPI: 1487091021
Provider Name (Legal Business Name): PARAGON QUALITY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2013
Last Update Date: 05/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 ROUTE 46 E
HACKETTSTOWN NJ
07840-2683
US

IV. Provider business mailing address

427 ROUTE 46 E
HACKETTSTOWN NJ
07840-2683
US

V. Phone/Fax

Practice location:
  • Phone: 908-498-0102
  • Fax: 908-498-0202
Mailing address:
  • Phone: 908-498-0102
  • Fax: 908-498-0202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number60A008
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number60A008
License Number StateNJ

VIII. Authorized Official

Name: MRS. KIMBERLY BETH POLACHEK
Title or Position: EXECUTIVE DIRECOR
Credential: CALA
Phone: 908-498-0102