Provider Demographics
NPI:1942617550
Name:A PATHWAY TO INDEPENDENCE
Entity Type:Organization
Organization Name:A PATHWAY TO INDEPENDENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VONNER
Authorized Official - Middle Name:G
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-794-0224
Mailing Address - Street 1:PO BOX 485
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:NC
Mailing Address - Zip Code:27983-0485
Mailing Address - Country:US
Mailing Address - Phone:252-794-0224
Mailing Address - Fax:
Practice Address - Street 1:128 E GRANVILLE ST
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:NC
Practice Address - Zip Code:27983-6754
Practice Address - Country:US
Practice Address - Phone:252-794-0224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health