# PARADISE LANDING 1

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

## Provider details

- **NPI number:** 1588140040
- **Authorized official:** DEIDRE TABORN (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (252) 572-4262

## Contact information

- **Practice address:** 1533 BRIGGS RD, HENDERSON, NC 27537-3898
- **Practice address phone:** (252) 572-4262
- **Mailing address:** 1533 BRIGGS RD, HENDERSON, NC 27537-3898

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 07/17/2018
- **Last updated:** 07/17/2018