Healthcare Provider Details

I. General information

NPI: 1427763614
Provider Name (Legal Business Name): PATHWAY TO NEW BEGINNINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 12/14/2023
Certification Date: 12/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3660 E UNIVERSITY DR STE 6B
MESA AZ
85205-6960
US

IV. Provider business mailing address

3660 E UNIVERSITY DR STE 6B
MESA AZ
85205-6960
US

V. Phone/Fax

Practice location:
  • Phone: 602-903-5051
  • Fax:
Mailing address:
  • Phone: 602-903-5051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. AMMA SERWAA ASHITEY
Title or Position: OWNER
Credential:
Phone: 602-903-5051