# PARADISE HOME SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417502261
- **Authorized official:** MRS. JERRILYN ADKISSON (OWNER)
- **Authorized official phone:** (573) 471-3770

## Contact information

- **Practice address:** 2232 MAIN ST, SCOTT CITY, MO 63780-1329
- **Practice address phone:** (573) 398-9196
- **Practice address fax:** (573) 398-9215
- **Mailing address:** 208 N INGRAM RD, SIKESTON, MO 63801-5233
- **Mailing address phone:** (573) 471-3770

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | — | NULL | — |
| 163W00000X | Registered Nurse | — | — | — |
| 163WH0200X | Home Health Registered Nurse | — | NULL | — |
| 163WH0200X | Home Health Registered Nurse | — | — | — |
| 164W00000X | Licensed Practical Nurse | — | NULL | — |
| 164W00000X | Licensed Practical Nurse | — | — | — |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 251J00000X | Nursing Care Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | — | NULL | — |
| 372600000X | Adult Companion | — | NULL | — |
| 372600000X | Adult Companion | — | — | — |
| 374U00000X | Home Health Aide | — | NULL | — |
| 374U00000X | Home Health Aide | — | — | — |
| 376J00000X | Homemaker | — | NULL | — |
| 376J00000X | Homemaker | — | — | — |
| 376K00000X | Nurse's Aide | — | NULL | — |
| 376K00000X | Nurse's Aide | — | — | — |
| 385H00000X | Respite Care | — | NULL | — |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | NULL | — |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | — | — |

## Other

- **Enumeration date:** 08/08/2019
- **Last updated:** 08/08/2019