Provider Demographics
NPI:1780081174
Name:PATHWAYS TO A BETTER LIFE, LLC
Entity type:Organization
Organization Name:PATHWAYS TO A BETTER LIFE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEATTIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-286-0189
Mailing Address - Street 1:PO BOX 347
Mailing Address - Street 2:
Mailing Address - City:KIEL
Mailing Address - State:WI
Mailing Address - Zip Code:53042-0347
Mailing Address - Country:US
Mailing Address - Phone:920-894-1374
Mailing Address - Fax:920-894-3408
Practice Address - Street 1:13111 LAX CHAPEL RD
Practice Address - Street 2:
Practice Address - City:KIEL
Practice Address - State:WI
Practice Address - Zip Code:53042-3954
Practice Address - Country:US
Practice Address - Phone:920-894-1374
Practice Address - Fax:920-894-1373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-01
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No251S00000XAgenciesCommunity/Behavioral Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1265068415Medicaid
WI1861022022Medicaid
WI1053468207Medicaid
WI1336105501Medicaid
WI1780262840Medicaid
WI1659907392Medicaid