Provider Demographics
NPI:1528830239
Name:POSITIVE PATHWAYS MENTAL HEALTH LLC
Entity type:Organization
Organization Name:POSITIVE PATHWAYS MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RATHEAL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:435-669-7517
Mailing Address - Street 1:139 SAND LAKE ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-1654
Mailing Address - Country:US
Mailing Address - Phone:435-669-7517
Mailing Address - Fax:
Practice Address - Street 1:139 SAND LAKE ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-1654
Practice Address - Country:US
Practice Address - Phone:435-669-7517
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-25
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health