Healthcare Provider Details

I. General information

NPI: 1275142689
Provider Name (Legal Business Name): PARA PROFESSIONAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2020
Last Update Date: 07/31/2020
Certification Date: 07/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S. EXECUTIVE DR. SUITE 101
BROOKFIELD WI
53005-4216
US

IV. Provider business mailing address

200 S. EXECUTIVE DR. SUITE 101
BROOKFIELD WI
53005-4216
US

V. Phone/Fax

Practice location:
  • Phone: 262-789-2740
  • Fax: 262-789-6699
Mailing address:
  • Phone: 262-789-2740
  • Fax: 262-789-6699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. DIONE NICOLE PATTON
Title or Position: CEO/HUMAN RESOURCES
Credential: BA/CNA
Phone: 262-789-2740