Provider Demographics
NPI:1639563422
Name:ST. FRANCIS PATHWAYS TO HEALTHCARE, LLC
Entity Type:Organization
Organization Name:ST. FRANCIS PATHWAYS TO HEALTHCARE, LLC
Other - Org Name:ST FRANCIS REFLECTIONS LIFESTAGE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-242-5386
Mailing Address - Street 1:1250 GRUMMAN PL STE B
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32780-7927
Mailing Address - Country:US
Mailing Address - Phone:321-269-4240
Mailing Address - Fax:
Practice Address - Street 1:1250 GRUMMAN PL STE B
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780-7927
Practice Address - Country:US
Practice Address - Phone:321-269-4240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-19
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty