Provider Demographics
NPI:1235792706
Name:PATHWAY TO PURPOSE EARLY LEARNING CENTER LLC
Entity Type:Organization
Organization Name:PATHWAY TO PURPOSE EARLY LEARNING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHAY
Authorized Official - Middle Name:MONAE
Authorized Official - Last Name:BUCKNER
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:216-990-4569
Mailing Address - Street 1:3703 W 135TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-3323
Mailing Address - Country:US
Mailing Address - Phone:216-990-4569
Mailing Address - Fax:
Practice Address - Street 1:1536 SAINT CLAIR AVE NE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-2004
Practice Address - Country:US
Practice Address - Phone:216-220-7250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-19
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty