Provider Demographics
NPI:1487091021
Name:PARAGON QUALITY, LLC
Entity type:Organization
Organization Name:PARAGON QUALITY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:POLACHEK
Authorized Official - Suffix:
Authorized Official - Credentials:CALA
Authorized Official - Phone:908-498-0102
Mailing Address - Street 1:427 ROUTE 46 E
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-2683
Mailing Address - Country:US
Mailing Address - Phone:908-498-0102
Mailing Address - Fax:908-498-0202
Practice Address - Street 1:427 ROUTE 46 E
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-2683
Practice Address - Country:US
Practice Address - Phone:908-498-0102
Practice Address - Fax:908-498-0202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ60A008311500000X, 310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0029688Medicaid
NJNJ60A008OtherALR-NJ