Provider Demographics
NPI:1578025383
Name:A NEW PATHWAY LLC
Entity Type:Organization
Organization Name:A NEW PATHWAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:STUCKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-355-3737
Mailing Address - Street 1:1935 J N PEASE PL STE 102
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-4541
Mailing Address - Country:US
Mailing Address - Phone:704-616-0694
Mailing Address - Fax:980-422-0336
Practice Address - Street 1:1935 J N PEASE PL STE 102
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-4541
Practice Address - Country:US
Practice Address - Phone:704-616-0694
Practice Address - Fax:980-422-0336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-01
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children