Provider Demographics
NPI:1952681751
Name:PATHWAYS TO SELF DETERMINATION
Entity Type:Organization
Organization Name:PATHWAYS TO SELF DETERMINATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:A
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-723-7152
Mailing Address - Street 1:237 N OLD WOODWARD AVE
Mailing Address - Street 2:BUILDING A, SUITE 5
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-5305
Mailing Address - Country:US
Mailing Address - Phone:248-723-7152
Mailing Address - Fax:248-723-7162
Practice Address - Street 1:237 N OLD WOODWARD AVE
Practice Address - Street 2:BUILDING A, SUITE 5
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-5305
Practice Address - Country:US
Practice Address - Phone:248-723-7152
Practice Address - Fax:248-723-7162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No385H00000XRespite Care FacilityRespite Care