Provider Demographics
NPI:1467700732
Name:PATHWAYS HOPES CORNER
Entity Type:Organization
Organization Name:PATHWAYS HOPES CORNER
Other - Org Name:HOPES CORNER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:STAFF NURSE
Authorized Official - Prefix:MISS
Authorized Official - First Name:JACQUELYN
Authorized Official - Middle Name:ALTHEA
Authorized Official - Last Name:WHATLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:706-775-0544
Mailing Address - Street 1:756 WOODBURY HWY
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30222-1514
Mailing Address - Country:US
Mailing Address - Phone:706-775-0544
Mailing Address - Fax:
Practice Address - Street 1:756 WOODBURY HWY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:GA
Practice Address - Zip Code:30222-1514
Practice Address - Country:US
Practice Address - Phone:706-775-0544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PATHWAYS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-17
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN147778310500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness