Provider Demographics
NPI:1194585836
Name:PATHWAYS TO WELLNESS LLC
Entity type:Organization
Organization Name:PATHWAYS TO WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LEA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-400-1442
Mailing Address - Street 1:4228 NEW VISTAS CT NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-0706
Mailing Address - Country:US
Mailing Address - Phone:505-400-1442
Mailing Address - Fax:
Practice Address - Street 1:4228 NEW VISTAS CT NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-0706
Practice Address - Country:US
Practice Address - Phone:505-400-1442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-20
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty