Healthcare Provider Details

I. General information

NPI: 1669349932
Provider Name (Legal Business Name): PATHWAYS 2 PURPOSE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2025
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38811 RAMBLER AVE
PALMDALE CA
93550-3334
US

IV. Provider business mailing address

44620 VALLEY CENTRAL WAY # 1117
LANCASTER CA
93536-6533
US

V. Phone/Fax

Practice location:
  • Phone: 855-203-9390
  • Fax:
Mailing address:
  • Phone: 855-203-9390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: LEAH WALLACE JACOBS
Title or Position: OWNER
Credential:
Phone: 323-385-2684