Provider Demographics
NPI:1558773614
Name:NEXT GENERATIONS PATH
Entity Type:Organization
Organization Name:NEXT GENERATIONS PATH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-910-3230
Mailing Address - Street 1:3081 S VALLEY VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-7890
Mailing Address - Country:US
Mailing Address - Phone:702-910-3230
Mailing Address - Fax:702-910-3231
Practice Address - Street 1:3081 S VALLEY VIEW BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-7890
Practice Address - Country:US
Practice Address - Phone:702-910-3230
Practice Address - Fax:702-910-3231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-23
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)