Provider Demographics
NPI:1851269542
Name:WAYWARD SUN WELLNESS, LLC (DBA PERENNIAL PATHWAYS)
Entity type:Organization
Organization Name:WAYWARD SUN WELLNESS, LLC (DBA PERENNIAL PATHWAYS)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SYDNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-509-3497
Mailing Address - Street 1:4090 WESTOWN PKWY STE E
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-6760
Mailing Address - Country:US
Mailing Address - Phone:515-421-8554
Mailing Address - Fax:515-400-1373
Practice Address - Street 1:4090 WESTOWN PKWY STE E
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-6760
Practice Address - Country:US
Practice Address - Phone:515-421-8554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-25
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)