MEDICARE: PARADIGM, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558622175
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARADIGM, INC.

Provider Business Mailing Address
First Line	:	PO BOX 31091
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27833-1091
Country	:	US
Telephone Number	:	252-561-8112
Fax Number	:	252-561-7455

Provider Business Practice Location Address
First Line	:	2240 COLLEGE ST
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-6351
Country	:	US
Telephone Number	:	252-561-8112
Fax Number	:	252-561-7455

Authorized Official
Title or Position	:	CEO
Name	:	JASON BARNETT
Credential	:
Telephone Number	:	252-714-1230

Provider Enumeration Date	:	05/30/2012
Last Update Date	:	05/30/2012

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Directions to “PARADIGM, INC. ” Practice Location

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