Provider Demographics
NPI:1275334278
Name:PROSPERITY PATHWAYS FOUNDATION INC
Entity type:Organization
Organization Name:PROSPERITY PATHWAYS FOUNDATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANISSA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MCGARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-617-2062
Mailing Address - Street 1:PO BOX 491823
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30049-0031
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:750 FOREST PARK LN
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-2583
Practice Address - Country:US
Practice Address - Phone:678-617-2062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
No347E00000XTransportation ServicesTransportation Broker
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare