Healthcare Provider Details

I. General information

NPI: 1356442065
Provider Name (Legal Business Name): PATHWAYS TO ACHIEVEMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 01/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 S 20TH AVE W SUITE A
DULUTH MN
55806-3526
US

IV. Provider business mailing address

114 S 20TH AVE W SUITE A
DULUTH MN
55806-3526
US

V. Phone/Fax

Practice location:
  • Phone: 218-721-4732
  • Fax: 218-491-7185
Mailing address:
  • Phone: 218-721-4732
  • Fax: 218-491-7185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number404834200
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHAWN MARIE NEUMANN
Title or Position: PRESIDENT
Credential:
Phone: 218-721-4732