Provider Demographics
NPI:1124870597
Name:PATHWAY TO PEACE GUIDANCE SERVICES, LLC
Entity type:Organization
Organization Name:PATHWAY TO PEACE GUIDANCE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-854-7991
Mailing Address - Street 1:9007 WHITE LAUREL LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-0283
Mailing Address - Country:US
Mailing Address - Phone:713-854-7991
Mailing Address - Fax:
Practice Address - Street 1:12238 QUEENSTON BLVD STE G
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-5351
Practice Address - Country:US
Practice Address - Phone:713-854-7991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management