Provider Demographics
NPI:1588362479
Name:PATHWAYS RECOVERY CENTER 2, INC.
Entity type:Organization
Organization Name:PATHWAYS RECOVERY CENTER 2, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-348-4805
Mailing Address - Street 1:13312 RANCHERO RD # 18-168
Mailing Address - Street 2:
Mailing Address - City:OAK HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92344-4812
Mailing Address - Country:US
Mailing Address - Phone:626-348-4805
Mailing Address - Fax:626-210-1197
Practice Address - Street 1:779 IRON BARK LN
Practice Address - Street 2:
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-3616
Practice Address - Country:US
Practice Address - Phone:626-412-6812
Practice Address - Fax:626-210-1197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility