Healthcare Provider Details

I. General information

NPI: 1396677647
Provider Name (Legal Business Name): PATH TO PURPOSE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2291 W MARCH LN # A115
STOCKTON CA
95207-6652
US

IV. Provider business mailing address

20 HIDDEN ACRES DR
TABERNACLE NJ
08088-8502
US

V. Phone/Fax

Practice location:
  • Phone: 602-342-9430
  • Fax:
Mailing address:
  • Phone: 609-342-9430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY MEISE
Title or Position: CEO FOUNDER
Credential:
Phone: 609-342-9430