Organization
PARADISE HOME SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JERRILYN ADKISSON (OWNER)
(573) 471-3770
Entity
Organization
Contact information
Practice address
2232 MAIN ST, SCOTT CITY, MO 63780-1329
(573) 398-9196
(573) 398-9215
Mailing address
208 N INGRAM RD, SIKESTON, MO 63801-5233
(573) 471-3770
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
163WH0200X
Home Health Registered Nurse
—
—
164W00000X
Licensed Practical Nurse
—
—
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
376K00000X
Nurse's Aide
—
—
385H00000X
Respite Care
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/08/2019
Last updated
08/08/2019
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