Organization
TRAVEL PARADISE VACATIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEQUESOR LYNETTE DAVIS PASTOR (CHIEF EXECTIVE DIRECTOR/ MANAGER)
(225) 270-5055
Entity
Organization
Contact information
Practice address
1459 WILD BLOSSOM WAY, CASTLE ROCK, CO 80104-7635
(225) 333-9220
(303) 997-9810
Mailing address
1459 WILD BLOSSOM WAY, CASTLE ROCK, CO 80104-7635
(225) 333-9220
(303) 997-9810
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
062770743
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G240420
—
CO
Enumeration date
03/15/2018
Last updated
03/19/2019
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