Provider Demographics
NPI:1376737361
Name:PATHWAYS BEHAVIORAL HEALTH SERVICE INC.
Entity Type:Organization
Organization Name:PATHWAYS BEHAVIORAL HEALTH SERVICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C EO
Authorized Official - Prefix:MR
Authorized Official - First Name:JIMMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-745-5761
Mailing Address - Street 1:594 HALLS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-5722
Mailing Address - Country:US
Mailing Address - Phone:252-745-5761
Mailing Address - Fax:252-745-7750
Practice Address - Street 1:594 HALLS CREEK RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-5722
Practice Address - Country:US
Practice Address - Phone:252-745-5761
Practice Address - Fax:252-745-7750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-01
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL069006251S00000X, 320600000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409210Medicaid