Organization
PARAGON UC SUPPORT SERVICES, LLO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE A MIRJAFARI MD (PHYSICIAN OWNER)
(918) 406-2024
Entity
Organization
Contact information
Practice address
77 E BRIDGE ST, STE B, OSWEGO, NY 13126
(918) 406-2024
Mailing address
6746 WARD RD, NIAGRA FALLS, NY 14304
(716) 622-2176
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/25/2023
Last updated
08/25/2023
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