Basic Information
| Provider Information | |||||||||
| NPI: | 1427479856 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PARAGON REHABILITATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 761 DEARBORN AVE | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436052503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193451161 | ||||||||
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| Practice Location | |||||||||
| Address1: | 303 N HURSTBOURNE PKWY | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402225185 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5024125847 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2014 | ||||||||
| LastUpdateDate: | 01/03/2014 | ||||||||
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| AuthorizedOfficialLastName: | ROGERS | ||||||||
| AuthorizedOfficialFirstName: | DANIELLE | ||||||||
| AuthorizedOfficialMiddleName: | MARY | ||||||||
| AuthorizedOfficialTitleorPosition: | SPEECH-LANGUAGE PATHOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 4193451161 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MISS | ||||||||
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| AuthorizedOfficialCredential: | M.A., CCC-SLP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | SP10875 | OH | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.