Organization
PAX RESIDENTIAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINNY SHAFFER CPCS (LICENSING AND CREDENITALING)
(765) 225-8298
Entity
Organization
Contact information
Practice address
1420 SPRING ST, JEFFERSONVILLE, IN 47130-3740
(812) 260-1177
(812) 410-4329
Mailing address
10461 MILL RUN CIR STE 810, OWINGS MILLS, MD 21117-5549
(410) 807-8471
(410) 525-5560
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
07/06/2026
Last updated
07/06/2026
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