Paradise Lodge LLC
NPI #1093386450 in Maricopa, Arizona
Provider Information
- NPI Number
- 1093386450
- Entity Type
- Organization
- Organization Name
- Paradise Lodge LLC
- Primary Specialty
- Substance Abuse Rehabilitation Facility
- Enumeration Date
- Jul 7, 2021
- Last Updated
- Jul 7, 2021
Practice Location
Authorized Official
- Name
- ERNEST KWESI AMPONSAH
- Title
- ADMINISTRATOR
- Phone
- (224) 595-0112
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Mental Illness |
| Psychiatric Residential Treatment Facility |
| Substance Abuse Rehabilitation Facility |
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