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General NPI Number Information
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NPI Number | 1073638342
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Entity Type | Organization
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Legal Business Name | PARAGON COMMUNITY SERVICES LLC
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3030 S CALHOUN RD
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City | NEW BERLIN
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State | WI
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Zip | 53151
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Country | US
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Telephone | 262-780-0814
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Fax | 262-782-3682
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Provider Business Mailing Address
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Address Line | PO BOX 278
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City | DOUSMAN
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State | WI
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Zip | 53118
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Country | US
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Telephone | 262-569-5515
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Fax | 262-569-9962
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MS. M DEBORAH FRISK
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Credential | MSW
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Telephone | 26205695515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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