Healthcare Provider Details

I. General information

NPI: 1063337129
Provider Name (Legal Business Name): PATHWAY TO PROGRESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 09/06/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 W HURON ST STE 101
PONTIAC MI
48341-1525
US

IV. Provider business mailing address

255 CARRIAGE CIRCLE DR APT 213
PONTIAC MI
48342-3367
US

V. Phone/Fax

Practice location:
  • Phone: 888-788-0524
  • Fax:
Mailing address:
  • Phone: 248-982-0790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: SHAWN MADDEN
Title or Position: MANAGER/PARTNER
Credential:
Phone: 248-982-9790