Organization
PARADISE 2 PRP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IGOR CHERNYAKHOVSKY (MANAGING MEMBER)
(443) 691-8522
Entity
Organization
Contact information
Practice address
7902 BELAIR RD, SUITE 4, NOTTINGHAM, MD 21236-3707
(443) 691-8522
(410) 325-1642
Mailing address
7902 BELAIR RD, SUITE 4, NOTTINGHAM, MD 21236-3707
(443) 691-8522
(410) 325-1642
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
23093
MD
Other
Enumeration date
05/21/2009
Last updated
05/21/2009
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