Provider Demographics
NPI:1336621598
Name:NEW PATHWAY FOR HEALING MINDS LLC
Entity Type:Organization
Organization Name:NEW PATHWAY FOR HEALING MINDS LLC
Other - Org Name:NEW PATHWAY FOR HEALING MINDS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-527-0660
Mailing Address - Street 1:1424 N SANDHILL RD APT 7
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-1218
Mailing Address - Country:US
Mailing Address - Phone:702-353-3871
Mailing Address - Fax:
Practice Address - Street 1:1424 N SANDHILL RD APT 7
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-1218
Practice Address - Country:US
Practice Address - Phone:702-527-0660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20181627992251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health