Provider Demographics
NPI:1780986802
Name:PATHWAYS TO LIFE, INC.
Entity type:Organization
Organization Name:PATHWAYS TO LIFE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ONTARIO
Authorized Official - Middle Name:LAMONT
Authorized Official - Last Name:CHAPPELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-347-6455
Mailing Address - Street 1:6330 N CENTER DR
Mailing Address - Street 2:BUILDING 13, SUITE 201
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-4008
Mailing Address - Country:US
Mailing Address - Phone:252-695-0269
Mailing Address - Fax:
Practice Address - Street 1:6330 N CENTER DR
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-4008
Practice Address - Country:US
Practice Address - Phone:252-344-7645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-22
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1229251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health