Organization
PARAGON OUTPATIENT THERAPY SERVICES,LLC
Active
Other names
PARAGON HEALTHCARE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE VICTORIA MCKIERNAN MHA (CHIEF ADMINISTRATOR)
(702) 914-2790
Entity
Organization
Contact information
Practice address
1655 W. HORIZON RIDGE PKWY., SUITE 100, HENDERSON, NV 89012-3494
(702) 914-2790
(702) 914-5984
Mailing address
1655 W. HORIZON RIDGE PKWY., SUITE 100, HENDERSON, NV 89012-3494
(702) 914-2790
(702) 914-5984
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100501129
—
NV
Enumeration date
11/20/2006
Last updated
04/08/2011
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