PARADISE ADOLESCENT HOME, INC. (NPI# 1740897784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740897784 |
| Entity Type | Organization |
| Organization Name | PARADISE ADOLESCENT HOME, INC. |
| Practice Address |
602 Woodlark Dr Suisun City CA 94585-2244 |
| Mailing Address |
Po Box 626 San Ramon CA 94583-0626 |
| Practice Telephone | 7073998907 |
| Mailing Telephone | 9259010219 |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2020-09-24 |
| Authorized Official Name | MARITZA JEFFERSON-GREGORY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9255708498 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902412182 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 136 Valdivia Cir, San Ramon, CA 94583-2228 | 2020-09-22 |
| Street Address |
602 WOODLARK DR |
| City | SUISUN CITY |
| State | CA |
| Zip Code | 94585-2244 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417491945 | Amber Harczak | Behavioral Analyst | 792 Sunset Avenue 12, Suisun City, CA 94585 | 2016-12-19 |
| 1427151919 | Bejan A Pazdel | Chiropractor | 258i Sunset Ave, Suisun, CA 94585 | 2006-09-07 |
| 1154424190 | Racquel Dela Cruz Dizon-samson | Registered Nurse | 229 Bridgewater Circle, Suisun City, CA 94585 | 2006-09-06 |
| 1346350667 | Pazdel Chiropractic Inc | Chiropractor | 258 Sunset Ave, Ste I, Suisan, CA 94585 | 2006-08-30 |
| 1275682122 | James Eddie Austin | Counselor | 159 Sunshine St, Suisun City, CA 94585-1301 | 2007-01-09 |
| 1710518667 | Jasmine J Evans | Behavioral Analyst | 206 Railroad Ave Apt 1205, Suisun City, CA 94585-1304 | 2020-01-29 |
| 1912518879 | Anna Paulina P Valdeavilla | Licensed Vocational Nurse | 88 Mosswood Dr, Suisun City, CA 94585-1718 | 2020-08-13 |
| 1215576723 | Nikki Rose Lavares | Behavior Technician | 61 Terry Ln, Suisun City, CA 94585-1732 | 2019-12-31 |
| 1770713927 | Lorraine Cornell | Occupational Therapist | 1604 Hickam Cir, Suisun City, CA 94585-1744 | 2009-07-22 |
| 1346865540 | Yulissa Leon | Technician | 78 Rodondo Ave, Suisun City, CA 94585-1745 | 2020-06-12 |
| Find all providers in zip 94585 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820499 | Catholic Charities of The Diocese of Oakland | Residential Treatment Facility, Emotionally Disturbed Children | 3700 Dorisa Ave, Oakland, CA 94605-4941 | 2020-10-27 |
| 1922607944 | Inspire A Youth, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 7556 Avenida Baja, Riverside, CA 92509-3449 | 2020-10-21 |
| 1235736554 | Yvonne Dionne Robinson | Residential Treatment Facility, Emotionally Disturbed Children | 1223 E Helmick St, Carson, CA 90746-3163 | 2020-10-09 |
| 1548877657 | T & T House of Champions | Residential Treatment Facility, Emotionally Disturbed Children | 2115 High St, Oakland, CA 94601-4335 | 2020-09-23 |
| 1902412182 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 136 Valdivia Cir, San Ramon, CA 94583-2228 | 2020-09-22 |
| 1073128492 | Samuel Campbell Jr. | Residential Treatment Facility, Emotionally Disturbed Children | 4200 Crescent Rock Ln, Bakersfield, CA 93311-2860 | 2020-09-11 |
| 1336753433 | Aaron's Boys Home | Residential Treatment Facility, Emotionally Disturbed Children | 5805 Capistrano Ave Ste E, Atascadero, CA 93422-7218 | 2020-09-04 |
| 1699389452 | Millie's Youth Services, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2512 Havenscourt Blvd, Oakland, CA 94605-1935 | 2020-08-31 |
| 1538779871 | Hidden Treasures Foundation, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 1240 W 13th Ave, Escondido, CA 92025-5560 | 2020-08-02 |
| 1174132807 | Harvest Safe Haven for Boys | Residential Treatment Facility, Emotionally Disturbed Children | 5425 Sierra Vista Ave, Riverside, CA 92505-3113 | 2020-07-28 |
| Find all providers with the same taxonomy | ||||
| City | SUISUN CITY |
| Zip Code | 94585 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.