Provider Demographics
NPI:1780457945
Name:BEHAVIORAL PATHWAYS, INC.
Entity type:Organization
Organization Name:BEHAVIORAL PATHWAYS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA
Authorized Official - Phone:661-974-4496
Mailing Address - Street 1:11930 AMARGOSA RD. SUITE 1
Mailing Address - Street 2:#1037
Mailing Address - City:VICTORVILLLE
Mailing Address - State:CA
Mailing Address - Zip Code:92392
Mailing Address - Country:US
Mailing Address - Phone:661-974-4496
Mailing Address - Fax:213-214-0629
Practice Address - Street 1:4841 W AVE. L14 APT. 10
Practice Address - Street 2:#1037
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536
Practice Address - Country:US
Practice Address - Phone:661-974-4496
Practice Address - Fax:213-214-0629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-31
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health