Provider Demographics
NPI:1437861069
Name:YOUR PATH TO GROW LLC
Entity Type:Organization
Organization Name:YOUR PATH TO GROW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ANATH
Authorized Official - Middle Name:
Authorized Official - Last Name:NEVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-644-6424
Mailing Address - Street 1:265 HACKENSACK ST UNIT 1212
Mailing Address - Street 2:
Mailing Address - City:WOOD RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07075-1253
Mailing Address - Country:US
Mailing Address - Phone:215-789-5002
Mailing Address - Fax:
Practice Address - Street 1:134 HICKORY AVE
Practice Address - Street 2:
Practice Address - City:TENAFLY
Practice Address - State:NJ
Practice Address - Zip Code:07670-1512
Practice Address - Country:US
Practice Address - Phone:215-789-5002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-14
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty