Provider Demographics
NPI:1972284701
Name:COMPASSION PATHWAY BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:COMPASSION PATHWAY BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:IFEANYI
Authorized Official - Middle Name:
Authorized Official - Last Name:EZEANI
Authorized Official - Suffix:
Authorized Official - Credentials:DBA
Authorized Official - Phone:530-888-5000
Mailing Address - Street 1:5410 WHITE LOTUS WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-4354
Mailing Address - Country:US
Mailing Address - Phone:530-888-5000
Mailing Address - Fax:
Practice Address - Street 1:1901 BARNEY RD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:CA
Practice Address - Zip Code:96007-4301
Practice Address - Country:US
Practice Address - Phone:530-888-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness