Healthcare Provider Details

I. General information

NPI: 1922512508
Provider Name (Legal Business Name): PATHWAYS RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2017
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 KENSINGTON DR
ROSEVILLE CA
95661-5312
US

IV. Provider business mailing address

PO BOX 847
FOLSOM CA
95763-0847
US

V. Phone/Fax

Practice location:
  • Phone: 916-622-0874
  • Fax:
Mailing address:
  • Phone: 916-532-4044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number310023AP
License Number StateCA

VIII. Authorized Official

Name: DANITA SANDS
Title or Position: EXECUTIVE DIRECTOR/CEO
Credential:
Phone: 916-532-4044