Provider Demographics
NPI:1821353558
Name:DIRECTED PATH, LLC
Entity Type:Organization
Organization Name:DIRECTED PATH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, QMHP, QSAP
Authorized Official - Phone:336-239-9201
Mailing Address - Street 1:280 HAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27288-7946
Mailing Address - Country:US
Mailing Address - Phone:336-239-9201
Mailing Address - Fax:336-358-4995
Practice Address - Street 1:1308 E STADIUM DR
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-3812
Practice Address - Country:US
Practice Address - Phone:336-612-2278
Practice Address - Fax:336-358-4995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-09
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children