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NPI Code Detail

MEDICARE: PATHWAYS TO LIFE, INC

MEDICARE: PATHWAYS TO LIFE, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1467695031
Entity Type Code : Organization
Provider Name (Legal Business Name) : PATHWAYS TO LIFE, INC
Provider Business Mailing Address
First Line : 150 E ARLINGTON BLVD STE E
Second Line :
City : GREENVILLE
State : NC
Zip : 27858-5019
Country : US
Telephone Number : 252-695-0269
Fax Number : 252-413-0526
Provider Business Practice Location Address
First Line : 1015 CONFERENCE DR
Second Line :
City : GREENVILLE
State : NC
Zip : 27858-5969
Country : US
Telephone Number : 252-695-0269
Fax Number : 252-413-0526
Authorized Official
Title or Position : PRESIDENT
Name : ONTARIO LAMONT CHAPPELL
Credential :
Telephone Number : 252-695-0269
Provider Enumeration Date : 04/13/2009
Last Update Date : 08/21/2020

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