Provider Demographics
NPI:1982028866
Name:PATHWAY FAMILY HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:PATHWAY FAMILY HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:WILLENE
Authorized Official - Middle Name:PETERS
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:225-205-0448
Mailing Address - Street 1:3864 ALETHA DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70814-4501
Mailing Address - Country:US
Mailing Address - Phone:225-231-1846
Mailing Address - Fax:855-898-9447
Practice Address - Street 1:8676 GOODWOOD BLVD
Practice Address - Street 2:SUITE 403
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-7914
Practice Address - Country:US
Practice Address - Phone:225-231-1846
Practice Address - Fax:855-898-9447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health