Provider Demographics
NPI:1912725920
Name:PATHWAYS ENHANCED CARE LLC
Entity type:Organization
Organization Name:PATHWAYS ENHANCED CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:FAY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BLAKE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:603-931-2676
Mailing Address - Street 1:31 DERRY ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-5004
Mailing Address - Country:US
Mailing Address - Phone:603-931-2676
Mailing Address - Fax:
Practice Address - Street 1:31 DERRY ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-5004
Practice Address - Country:US
Practice Address - Phone:603-931-2676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities