Basic Information
| Provider Information | |||||||||
| NPI: | 1699116020 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PARAGON REHAB | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4265 S WOODBRIDGE LN | ||||||||
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| City: | NEW PALESTINE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461639482 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 303 N HURSTBOURNE PKWY STE 200 | ||||||||
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| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402225158 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5024125847 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2013 | ||||||||
| LastUpdateDate: | 07/15/2013 | ||||||||
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| AuthorizedOfficialLastName: | KESSLER | ||||||||
| AuthorizedOfficialFirstName: | CHRISTINE | ||||||||
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| AuthorizedOfficialTitleorPosition: | SPEECH LANGUAGE PATHOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 3174416873 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 4600232A | IN | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.