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General NPI Number Information
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NPI Number | 1750798047
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Entity Type | Organization
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Legal Business Name | PARAGON COMMUNITY HEALTHCARE INC
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Dates
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Enumeration Date | 07/17/2014
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Last Update Date | 07/17/2014
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Provider Practice Location Address
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Address Line | 6131 US HIGHWAY 19
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-2507
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Country | US
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Telephone | 727-842-6900
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Fax | 727-842-6902
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Provider Business Mailing Address
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Address Line | 6131 US HIGHWAY 19
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-2507
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Country | US
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Telephone | 727-842-6900
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Fax | 727-842-6902
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. THEODORE KENNETH FERGUSON II
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Credential |
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Telephone | 727-842-6900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State | FL
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