Provider Demographics
NPI:1235989294
Name:PATHWAY BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:PATHWAY BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NII
Authorized Official - Middle Name:
Authorized Official - Last Name:OKAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-963-9816
Mailing Address - Street 1:45977 W RANCH RD
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85139-6813
Mailing Address - Country:US
Mailing Address - Phone:598-963-9816
Mailing Address - Fax:
Practice Address - Street 1:45977 W RANCH RD
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85139-6813
Practice Address - Country:US
Practice Address - Phone:508-963-9816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health