Provider Demographics
NPI:1609272145
Name:PATHWAYS TO LIFE, INC.
Entity Type:Organization
Organization Name:PATHWAYS TO LIFE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ONTARIO
Authorized Official - Middle Name:LAMONT
Authorized Official - Last Name:CHAPPELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-695-0269
Mailing Address - Street 1:1200 E FIRE TOWER RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-4196
Mailing Address - Country:US
Mailing Address - Phone:252-695-0269
Mailing Address - Fax:252-413-0526
Practice Address - Street 1:4228 1ST AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-4426
Practice Address - Country:US
Practice Address - Phone:252-695-0269
Practice Address - Fax:252-413-0526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-11
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health