Healthcare Provider Details

I. General information

NPI: 1346652476
Provider Name (Legal Business Name): NEW PATHWAYS FOR CHILDREN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2014
Last Update Date: 05/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3311 SHAW RD
MELBER KY
42069-8738
US

IV. Provider business mailing address

PO BOX 10
MELBER KY
42069-0010
US

V. Phone/Fax

Practice location:
  • Phone: 270-674-6013
  • Fax: 270-674-0599
Mailing address:
  • Phone: 270-674-6061
  • Fax: 270-674-6065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number500264
License Number StateKY

VIII. Authorized Official

Name: JOSEPH WILLIAMS
Title or Position: TREATMENT DIRECTOR
Credential: LCSW
Phone: 270-247-5667