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General NPI Number Information
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NPI Number | 1811240344
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Entity Type | Organization
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Legal Business Name | PARADIGM, INC.
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Dates
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Enumeration Date | 10/22/2012
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Last Update Date | 10/13/2017
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Provider Practice Location Address
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Address Line | 4558 REEDY BRANCH RD
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City | WINTERVILLE
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State | NC
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Zip | 28590-8925
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Country | US
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Telephone | 252-561-8112
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Fax | 252-561-7455
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Provider Business Mailing Address
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Address Line | PO BOX 31091
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City | GREENVILLE
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State | NC
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Zip | 27833-1091
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Country | US
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Telephone | 252-561-8112
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Fax | 252-561-7455
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Authorized Official
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Title or Position | CEO
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Name | JASON BARNETT
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Credential | RN
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Telephone | 252-561-8112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | MHL-098-180
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MHL098180
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License Number State | NC
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