Healthcare Provider Details

I. General information

NPI: 1679352876
Provider Name (Legal Business Name): PARAMOUNT HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2023
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3136 TAOS MEADOWS DR NE
RIO RANCHO NM
87144-8587
US

IV. Provider business mailing address

3136 TAOS MEADOWS DR NE
RIO RANCHO NM
87144-8587
US

V. Phone/Fax

Practice location:
  • Phone: 505-453-1552
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAIVEN JEAN DE CHANTAL
Title or Position: FNP
Credential: CNP
Phone: 505-231-1650