| Paradise Mental Health Center Llc | |
|
407 N Hamilton St Dalton GA 30720-3124 | |
| (786) 774-7135 | |
| Not Available |
| Full Name | Paradise Mental Health Center Llc |
|---|---|
| Speciality | Psychologist |
| Location | 407 N Hamilton St, Dalton, Georgia |
| Authorized Official Name and Position | Osmany Gutierrez (OWNER) |
| Authorized Official Contact | 7867747135 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paradise Mental Health Center Llc 407 N Hamilton St Dalton GA 30720-3124 Ph: (786) 774-7135 | Paradise Mental Health Center Llc 407 N Hamilton St Dalton GA 30720-3124 Ph: (786) 774-7135 |
| NPI Number | 1548936941 |
|---|---|
| Provider Enumeration Date | 08/17/2021 |
| Last Update Date | 12/08/2021 |
| Certification Date | 12/08/2021 |
| Medicare PECOS PAC ID | 7214321389 |
|---|---|
| Medicare Enrollment ID | O20220307001268 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548936941 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Jonathan Guy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871746990 PECOS PAC ID: 8820286578 Enrollment ID: I20130813000270 |
| Provider Name | Maria C Santana |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1700070406 PECOS PAC ID: 7719256569 Enrollment ID: I20170710003151 |
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