Healthcare Provider Details

I. General information

NPI: 1770963944
Provider Name (Legal Business Name): PATHWAYS HOSPICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2015
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4075 W 11TH ST
GREELEY CO
80634-2530
US

IV. Provider business mailing address

305 CARPENTER RD
FORT COLLINS CO
80525-4248
US

V. Phone/Fax

Practice location:
  • Phone: 970-356-4090
  • Fax:
Mailing address:
  • Phone: 970-663-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: TIM J BOWEN
Title or Position: CEO
Credential:
Phone: 303-398-6203