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General NPI Number Information
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NPI Number | 1861517088
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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 | 03/20/2007
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Last Update Date | 09/10/2007
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Provider Practice Location Address
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Address Line | 4001 OLD PACTOLUS RD # A
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City | GREENVILLE
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State | NC
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Zip | 27834-0701
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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 | EXECUTIVE DIRECTOR
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Name | MR. JASON TREMAIN BARNETT
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Credential | RN
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Telephone | 252-714-1230
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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 | MHL-074-136
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License Number State | NC
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