Healthcare Provider Details

I. General information

NPI: 1902552151
Provider Name (Legal Business Name): PATHWAY SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2022
Last Update Date: 02/28/2022
Certification Date: 02/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 JESSUP GROVE RD
GREENSBORO NC
27410-9407
US

IV. Provider business mailing address

1814 SAVANNAS RUN DR
GREENSBORO NC
27405-1699
US

V. Phone/Fax

Practice location:
  • Phone: 336-542-0069
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: JESSICA FOSTER
Title or Position: PRESIDENT
Credential:
Phone: 336-987-4578